Organization Active NPI

Garrett S Bode DC PA

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1740442623
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GARRETT S BODE DC PA
Practice address
13694 W Hillsborough Ave
Tampa, FL 33635-9638
Phone
(813) 891-1600
Fax
(813) 891-1660
NPI assigned
Jul 1, 2008
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Dr. Garrett S Bode, D.C.NPI 1760406409
Title
Owner
Phone
(813) 891-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

13694 W Hillsborough Ave
Tampa, FL 33635-9638

Mailing address

13694 W Hillsborough Ave
Tampa, FL 33635-9638
Phone (813) 891-1600

Other identifiers 1

IdentifierTypeStateIssuer
381566800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080804000336 FL Part B Supplier - Clinic/Group Practice 2961576392 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

13694 W Hillsborough Ave
Tampa, FL 33635
Phone (813) 891-1600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1740442623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13694 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359638",
            "telephone_number": "813-891-1600",
            "fax_number": "813-891-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13694 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359638",
            "telephone_number": "813-891-1600",
            "fax_number": "813-891-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARRETT S BODE DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "BODE",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-891-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381566800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.