Dale Michael Bodmer, LMT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4589 Kenny Rd Ste 101
Columbus, OH 43220-2778

Phone

(614) 578-7470

Fax

(855) 578-7470

NPI assigned

Jun 30, 2006

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ohio Life Balance Physical Therapy Limited Partnership

  dba Life Balance Physical Therapy

  • Physical Therapist
  • Galloway, OH
  • NPI 1740500693
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1679502132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3474 CASTLETON ST",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431232125",
            "telephone_number": "614-578-7470",
            "fax_number": "855-578-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4589 KENNY RD STE 101",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202778",
            "telephone_number": "614-578-7470",
            "fax_number": "855-578-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODMER",
        "first_name": "DALE",
        "middle_name": "MICHAEL",
        "credential": "LMT, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.008563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan S Bode, MD
• Sara M Bode, M.D.
• Michael Moran Gilbert Bodell
• Robin Bodem, LMT
• Doug Bodin, PHD
• Natalie S Bodnar, DO
• Olivia Louise Bodnar
• Robin Bodner, RN
• Deborah Oluwakemi Bodunde
• Bodylogic MD of Columbus, LLC (BodyLogic MD of Columbus)

• Physical Therapist in Columbus, OH
• Providers in Columbus, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.