Kitti-Kaye Bodley, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301098624 Issued in MI

Practice address

1 Hurley PLZ
Flint, MI 48503-5902

Phone

(810) 262-9795

NPI assigned

Jul 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbodley1117937@direct.hfhs.org
• Direct secure messaging: kbodley67594@direct.hurleymc.com

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.

• Henry Ford Health Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236

  Single Specialty

  Medicare reassignment NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549

  Single Specialty

  Medicare reassignment NPD
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  Medicare reassignment
• Henry Ford Health Providence Hospital

  • Neonatal-Perinatal Medicine Physician
  • Southfield, MI
  • NPI 1003871062

  Single Specialty

  NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD
• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  NPD (past)
• Hurley Medical Center

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1598717480
  NPD (past)

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1659668184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODLEY",
        "first_name": "KITTI-KAYE",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MI",
            "license": "1659668184",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301098624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby J Grossi DDS PC
• Tracie Bobrowski, BA, CMHP, QMHP, QIDP
• Dakota Jade Bobruk
• Michael Boczar, D.O.
• Ashana Bodiwala, MD
• Beth Anne Bodtker, PT
• Amanda Marie Weichert Boes, LMSW-CLINICAL
• Derrald Boggan
• Rachel Rene Boggan, MSW, DOULA
• Madonna Bogus

• Pediatrics Physician in Flint, MI
• Providers in Flint, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.