Individual provider Active NPI

Brynn Ann Bodermann, DPT

  • Physical Medicine & Rehabilitation Physician
  • Parkersburg, IA
National Provider Identifier
1801605167
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
123221 Issued in IA
Practice address
1306 Highway 57 Ste B
Parkersburg, IA 50665-1075
Phone
(319) 346-9783
Fax
(319) 346-9785
NPI assigned
Jan 2, 2025
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 123221 IA Primary

Addresses

Primary practice location

1306 Highway 57 Ste B
Parkersburg, IA 50665-1075

Mailing address

1306 Highway 57 Ste B
Parkersburg, IA 50665-1075
Phone (319) 346-9783

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250117002019 IA Practitioner - Physical Therapist in Private Practice 9830628940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

121 Tower St
Denver, IA 50622-2201
Phone (319) 406-0185

1306 Hwy 57
Suite B
Parkersburg, IA 50665-1075
Phone (319) 346-9783

1306 Hwy 57 B
Parkersburg, IA 50665-1049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123221IAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Physical Therapy Associates, LLC CurrentSince Jan 7, 2025 Accepting new patients
Taylor Physical Therapy Associates LLC Current Accepting new patients
Taylor Physical Therapy Assoc. LLC PastSince Mar 24, 2024 Accepting new patients

Locations

1306 Highway 57
Ste B
Parkersburg, IA 50665
Phone (319) 346-9783

1014 W 1st St
Sumner, IA 50674
Phone (563) 578-5125

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1801605167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 HIGHWAY 57 STE B",
            "city": "PARKERSBURG",
            "state": "IA",
            "postal_code": "506651075",
            "telephone_number": "319-346-9783",
            "fax_number": "319-346-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 HIGHWAY 57 STE B",
            "city": "PARKERSBURG",
            "state": "IA",
            "postal_code": "506651075",
            "telephone_number": "319-346-9783",
            "fax_number": "319-346-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODERMANN",
        "first_name": "BRYNN",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IA",
            "license": "123221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.