Individual provider Active NPI

Robert F. Boedy, MD

  • Neonatal-Perinatal Medicine Physician
  • Columbus, GA
National Provider Identifier
1437269149
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
034085 Issued in GA
Practice address
2122 Manchester Expy
Columbus, GA 31904-6878
Phone
(706) 320-2773
Fax
(706) 596-4226
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 034085 GA Primary

Addresses

Primary practice location

2122 Manchester Expy
Columbus, GA 31904-6878

Mailing address

PO Box 8147
Columbus, GA 31908-8147
Phone (706) 320-2773

Other identifiers 2

IdentifierTypeStateIssuer
000406249AMedicaidGA
G07002MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000821 GA Practitioner - Pediatric Medicine 2163497314 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034085GAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Putney Memorial Hospital Inc CurrentSince Nov 6, 2013 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 14, 2004 Accepting new patients
Phoebe Putney Memorial Hospital Inc Current Accepting new patients
Phoebe Women'S Services CurrentSince Nov 6, 2013 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 14, 2004 Accepting new patients

Locations

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1437269149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8147",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319088147",
            "telephone_number": "706-320-2773",
            "fax_number": "706-596-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046878",
            "telephone_number": "706-320-2773",
            "fax_number": "706-596-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEDY",
        "first_name": "ROBERT",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "034085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000406249A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G07002",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.