Peter Bodunrin

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

105622 Issued in GA

Practice address

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049

Phone

(404) 778-7777

NPI assigned

Apr 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Medical College of Georgia School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keller, Crymes, and Demarco LLCGroup PAC ID 3971591132, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S Hospital Hospital, Athens, GA, CCN 110006
• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Keller, Crymes, & Demarco LLC

  • Ophthalmology Physician
  • Athens, GA
  • NPI 1467406983

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Keller Crymes & Demarco LLC

  • Eyewear Supplier
  • Athens, GA
  • NPI 1790907277
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation
• St. Mary'S Hospital, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1871556621
  Care Compare affiliation

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1790363596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-778-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-778-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODUNRIN",
        "first_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "105622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Alexandria Bodkin, MD
• Adriana Alexandra Bodlak, MD
• Arthur D Bodner, DMD
• Gary Roy Bodner, M.D.
• Imre Bodo
• Peggy Ann Bodway, R.N.
• Body Logic of Atlanta
• Body Mechanics Physical Therapy LLC
• Bodywellness Physical Therapy, L.L.C.
• Betty Boecler, NNP-BC

• Ophthalmology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.