Individual provider Active NPI

James Robert Bodkin, B.S.,D.C.

  • Chiropractor
  • Chattanooga, TN
National Provider Identifier
1720310386
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2412 Issued in TN
Practice address
6102 Shallowford Rd
Suite 103
Chattanooga, TN 37421-1684
Phone
(423) 475-6438
NPI assigned
Feb 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2412 TN Primary

Addresses

Primary practice location

6102 Shallowford Rd
Suite 103
Chattanooga, TN 37421-1684

Mailing address

6102 Shallowford Rd
Suite 103
Chattanooga, TN 37421-1684
Phone (423) 475-6438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823002390 GA Practitioner - Chiropractic 1557493335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pray Chiropractic PCGroup PAC ID 9032358338, 3 clinicians

Practice addresses (Care Compare)

715 S Thornton Ave
Dalton, GA 30720-8213
Phone (706) 609-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2412TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pray Chiropractic P.C. Chiropractor CurrentSince Jul 1, 2019 Accepting new patients
Simply Chiropractic LLC Chiropractor PastSince Jun 15, 2010 Accepting new patients
Pray Chiropractic PC Chiropractor Past Accepting new patients

Locations

715 S Thornton Ave
Dalton, GA 30720
Phone (706) 609-0023

5721 Battlefield Pkwy
Ringgold, GA 30736
Phone (706) 835-7729

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1720310386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6102 SHALLOWFORD RD",
            "address_2": "SUITE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211684",
            "telephone_number": "423-475-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 SHALLOWFORD RD",
            "address_2": "SUITE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211684",
            "telephone_number": "423-475-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODKIN",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "B.S.,D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-08",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.