Emily Jane Bodfish

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110-006874 Issued in VA

Practice address

1204 N Main St
Marion, VA 24354-4312

Phone

(276) 783-2511

NPI assigned

Sep 6, 2019

Sex

Female

Sole proprietor

No

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.

• Abingdon Eye Associates, P.C.

  • Plastic Surgery Physician
  • Abingdon, VA
  • NPI 1548297070
  NPD (past)
• Mountainview Pediatrics, P.C.

  • Pediatrics Physician
  • Marion, VA
  • NPI 1528070216
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 2, 2020.

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1689223208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 HUTTON ST APT 7",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242103492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MAIN ST",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544312",
            "telephone_number": "276-783-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26208 Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117504",
            "country_code": "US",
            "telephone_number": "276-451-3044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODFISH",
        "first_name": "EMILY",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110-006874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Amy Rachelle Blue, O.D.
• David R Boehm, LCSW
• Kellie Bonsor, APRN, FNP-BC
• Boothe Chiropractic Clinic
• Boothe Chirpractic Center, LLC
• Samuel Kenneth Boothe, DC

• All providers in Marion, VA
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.