NPIMap

Individual provider Active NPI

Krystina Bodalia, M.D.

  • Family Medicine Physician
  • Liberty Township, OH
National Provider Identifier
1417337007
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.134653 Issued in OH
Practice address
6939 Cox Rd Ste 360
Liberty Township, OH 45069
Phone
(513) 564-6800
Fax
(513) 564-6815
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.134653 OH Primary

Addresses

Primary practice location

6939 Cox Rd Ste 360
Liberty Township, OH 45069

Mailing address

6939 Cox Rd Ste 360
Liberty Township, OH 45069-7595
Phone (513) 564-6800

Other identifiers 2

IdentifierTypeStateIssuer
7100550300MedicaidKY
0305000MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbodalia83300@direct.thechristhospital.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180820002270 OH Practitioner - Family Practice 9739476979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

7100 Graphics Way
Suite 2400
Lewis Center, OH 43035-0208
Phone (740) 953-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Inc Family Medicine CurrentSince Apr 9, 2023 Accepting new patients
Mount Carmel Health Providers Inc Family Medicine CurrentSince Apr 9, 2023 Accepting new patients
Christ Hospital Medical Specialists LLC PastSince Nov 1, 2020 Accepting new patients

Locations

7100 Graphics Way
Ste 2400
Lewis Center, OH 43035
Phone (740) 953-4100

55 N High St
New Albany, OH 43054
Phone (614) 627-1878

Interoperability endpoints

  • Direct secure messaging: kbodalia2588927@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1417337007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6939 COX RD STE 360",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450697595",
            "telephone_number": "513-564-6800",
            "fax_number": "513-564-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 COX RD STE 360",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "45069",
            "telephone_number": "513-564-6800",
            "fax_number": "513-564-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODALIA",
        "first_name": "KRYSTINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.134653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100550300",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0305000",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbodalia83300@direct.thechristhospital.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6939 Cox Rd Ste 360",
            "city": "Liberty Township",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Liberty Township, OH

Sources for this page

Verify at the official NPI Registry.