Individual provider Active NPI

Erin Bodenheimer, PHARMD

  • Pharmacist
  • Orlando, FL
National Provider Identifier
1477868677
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS56172 Issued in FL
Practice address
2100 N Orange Ave
Orlando, FL 32804-5516
Phone
(407) 897-5292
Fax
(407) 897-6635
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 061601 NY
Pharmacist 183500000X S017974 AZ
Pharmacist 183500000X PS56172 FL Primary

Addresses

Primary practice location

2100 N Orange Ave
Orlando, FL 32804-5516

Mailing address

2100 N Orange Ave
Orlando, FL 32804-5516
Phone (407) 897-5292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S017974AZMDPharmacist
PS56172FLMDPharmacist
061601NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bioscrip Pharmacy, Inc. PastSince Jun 12, 2022 Accepting new patients
Walgreen Co PastSince Apr 17, 2022 Accepting new patients
Walgreen Co PastSince Aug 1, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1477868677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045516",
            "telephone_number": "407-897-5292",
            "fax_number": "407-897-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045516",
            "telephone_number": "407-897-5292",
            "fax_number": "407-897-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHEIMER",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "061601",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017974",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS56172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.