Active NPI
Ernest G Bode Jr., M.D.
- Internal Medicine Physician
- Toledo, OH
National Provider Identifier
1730185646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35059876
- Practice address
- 2150 W Central Ave
Toledo, OH 43606-3846 - Phone
- (419) 291-2200
- Fax
- (419) 479-3298
- NPI assigned
- Jun 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35059876 | OH | Primary |
Addresses
Primary practice location
2150 W Central Ave
Toledo, OH 43606-3846
Mailing address
2150 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-4290
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00716 | Other | OH | NATIONWIDE |
| 142191 | Other | MI | CARE CHOICES |
| 4215933 | Medicaid | MI | |
| 0802082 | Medicaid | OH | |
| 4121861 | Other | OH | AETNA |
| 344428256 | Other | OH | EMERALD |
| 12801 | Other | MI | HPM |
| 142191 | Other | MI | PRIORITY |
| 344428256062 | Other | OH | CARESOURCES |
| 000000190757 | Other | OH | ANTHEM BC/BS |
| 01040 | Other | OH | PARAMOUNT PROVIDER NUMBER |
| 1613014002 | Other | OH | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35059876 | OH | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1730185646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 W CENTRAL AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063834",
"telephone_number": "419-291-4290",
"fax_number": "419-479-3263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 W CENTRAL AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063846",
"telephone_number": "419-291-2200",
"fax_number": "419-479-3298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODE",
"first_name": "ERNEST",
"middle_name": "G",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-24",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35059876",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONWIDE",
"identifier": "00716",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "142191",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4215933",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0802082",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4121861",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMERALD",
"identifier": "344428256",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPM",
"identifier": "12801",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY",
"identifier": "142191",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCES",
"identifier": "344428256062",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "000000190757",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT PROVIDER NUMBER",
"identifier": "01040",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1613014002",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.