Betty Boddie, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT36530 Issued in FL

Practice address

708 3Rd St N
Jacksonville Beach, FL 32250-7149

Phone

(904) 822-4622

NPI assigned

Jan 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Concierge Physio LLC

  dba Direct Orthopedic Therapy

  • Physical Therapist
  • Jacksonville Beach, FL
  • NPI 1013559632
  Medicare reassignment NPD

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1629848494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LINDA MAR DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806961",
            "telephone_number": "910-599-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 3RD ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322507149",
            "telephone_number": "904-822-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODDIE",
        "first_name": "BETTY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Rogers Bishop, NP
• Carly Black, MOT, OTR/L
• Blue Star Therapeutics Inc
• Catherine Ann Bobenrieth, M.D
• Reese Nola Bobo
• Kathleen Gersek Bodkin, RD, LD/N,CDE
• Richard J Boehme, MD
• Kamal I Bohsali, M.D.
• Leslie Margaret Bohsali, ARNP
• John G. Bordelon, MD

• Physical Therapist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.