Kendall Marie Bodine, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

301230 Issued in CA

Practice address

3355 Mission Ave Ste 123
Oceanside, CA 92058-1327

Phone

(760) 529-4975

NPI assigned

Nov 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Oceanside Therapy Group, Inc.

  • Speech-Language Pathologist
  • Oceanside, CA
  • NPI 1013246248
  NPD (past)

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1689331365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 S CITRUS AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920274209",
            "telephone_number": "425-563-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 MISSION AVE STE 123",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920581327",
            "telephone_number": "760-529-4975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6264 Ferris Sq",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213204",
            "country_code": "US",
            "telephone_number": "619-940-4128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODINE",
        "first_name": "KENDALL",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.sandiegooccupationaltherapy.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6264 Ferris Sq",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921213204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@oceansidetherapygroup.com",
            "affiliation": "N",
            "address_1": "3355 Mission Ave Ste 123",
            "city": "Oceanside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920581327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tia Blythe, DPT, OCS, SCS
• Brian S Bobick, D.P.M.
• Bonnie Ruth Bobzien, M.D.
• Debra Bochinski, LM, CPM
• Bradley Cobb Bockhorst, DMD
• Janie Michele Bodman, OD
• Mia Rose Bodnar
• Joel Boerth, PHARMD, BCPP
• Margaret Mary Bohan
• Marcie Alena Bokelman, RN

• Physical Therapist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.