Active NPI
Neil Clayton Bodick
- Adult Medicine Physician
- Indianapolis, IN
National Provider Identifier
1487818936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 01042005A
- Practice address
- 8517 Oakmont LN
Indianapolis, IN 46260-5340 - Phone
- (317) 251-6092
- NPI assigned
- Jul 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01042005A | IN | |
| Adult Medicine Physician | 207QA0505X | 01042005A | IN | Primary |
Addresses
Primary practice location
8517 Oakmont LN
Indianapolis, IN 46260-5340
Mailing address
8517 Oakmont LN
Indianapolis, IN 46260-5340
Phone (317) 251-6092
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01042005A | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1487818936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8517 OAKMONT LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462605340",
"telephone_number": "317-251-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8517 OAKMONT LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462605340",
"telephone_number": "317-251-6092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODICK",
"first_name": "NEIL",
"middle_name": "CLAYTON",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01042005A",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "IN",
"license": "01042005A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.