Individual provider Active NPI

Victoria Elizabeth Bodrie, RN

  • Home Health Registered Nurse
  • Trenton, MI
National Provider Identifier
1619463288
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
4704398305 Issued in MI
Practice address
3821 Syckelmoore St
Trenton, MI 48183-4115
Phone
(586) 354-8292
NPI assigned
Jul 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X MI
Home Health Registered Nurse 163WH0200X 4704398305 MI Primary

Addresses

Primary practice location

3821 Syckelmoore St
Trenton, MI 48183-4115

Mailing address

3821 Syckelmoore St
Trenton, MI 48183-4115
Phone (586) 354-8292

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704398305MIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1619463288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 SYCKELMOORE ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834115",
            "telephone_number": "586-354-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 SYCKELMOORE ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834115",
            "telephone_number": "586-354-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODRIE",
        "first_name": "VICTORIA",
        "middle_name": "ELIZABETH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-07",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MI",
            "license": "4704398305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.