Stephen Ross Bodine, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0016085 Issued in CO

Practice address

3488 Goni Rd Ste 141
Carson City, NV 89706-7970

Phone

(775) 887-5030

NPI assigned

Aug 11, 2012

Last updated

Jan 9, 2019By the provider in NPPES

Sex

Male

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 CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Alta Physical Therapy PCGroup PAC ID 0547253957, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alta Physical Therapy PC

  • Specialist
  • Boulder, CO
  • NPI 1578675120
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1700133550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 BASELINE RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032356",
            "telephone_number": "303-444-8707",
            "fax_number": "303-444-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3488 GONI RD STE 141",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897067970",
            "telephone_number": "775-887-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODINE",
        "first_name": "STEPHEN",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-11",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0016085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Boehme Dentists of Carson City, PC
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• Katie Bomberger, APRN
• Khara Bond

• Physical Therapist in Carson City, NV
• Providers in Carson City, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.