Individual provider Active NPI

Roberta Boddie

  • Case Manager/Care Coordinator
  • Fairlawn, OH
National Provider Identifier
1780595165
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3094 W Market St Ste 343
Fairlawn, OH 44333-3618
Phone
(234) 334-5589
NPI assigned
Sep 15, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH Primary

Addresses

Primary practice location

3094 W Market St Ste 343
Fairlawn, OH 44333-3618

Mailing address

3094 W Market St
Fairlawn, OH 44333-3626
Phone (234) 334-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1780595165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3094 W MARKET ST",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333626",
            "telephone_number": "234-334-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3094 W MARKET ST STE 343",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333618",
            "telephone_number": "234-334-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODDIE",
        "first_name": "ROBERTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.