Johnna L Bodenstab, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

100447 Issued in MO

Practice address

17611 East 24 Highway
Suite 200
Independence, MO 64055-1823

Phone

(816) 257-7787

Fax

(816) 257-6948

NPI assigned

Nov 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Digestive Health Specialists LLCGroup PAC ID 9739494832, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerpoint Medical Center Hospital, Independence, MO, CCN 260095
• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
• NKC Health Hospital, North Kansas City, MO, CCN 260096

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Digestive Health Specialists, LLC

  • Gastroenterology Physician
  • Independence, MO
  • NPI 1801286844
  Medicare reassignment Care Compare group NPD
• Consultants in Gastroenterology, PC

  • Specialist
  • Independence, MO
  • NPI 1932189768
  NPD (past)
• Independence Regional Medical Group LLC

  • Family Medicine Physician
  • Independence, MO
  • NPI 1922054295
  NPD (past)

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

• Centerpoint Medical Center of Independence, LLC

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  Care Compare affiliation
• North Kansas City Hospital

  • Skilled Nursing Facility
  • North Kansas City, MO
  • NPI 1437103215

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1629062799
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke'S Hospital of Kansas City

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1619968070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17611 EAST 24 HIGHWAY",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640561823",
            "telephone_number": "816-257-7787",
            "fax_number": "816-257-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17611 EAST 24 HIGHWAY",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640551823",
            "telephone_number": "816-257-7787",
            "fax_number": "816-257-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENSTAB",
        "first_name": "JOHNNA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "100447",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "100447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "000C892",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bluebird Home Healthcare LLC
• Carol A Blum, M.D.
• Steven Wayne Blum Jr., D.D.S.
• Calie Boberg
• Mary Bode-Smith, MS, LPC
• Cassie Jorae Bollinger
• Justine Barye Bolton, PT, DPT, ATC, LAT
• Carrie S Bond, LPC
• Melinda B Bonham, MED, MS, LMFT
• Tasha Bonilla, RBT

• Family Nurse Practitioner in Independence, MO
• Providers in Independence, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.