Edward James Bodmer, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0152 Issued in AZ

Practice address

9765 E Dead Sure PL
Gold Canyon, AZ 85218-7176

Phone

(480) 363-3066

Fax

(480) 983-8153

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• E. James Bodmer, D.P.M., PC

  • Health Service Clinic/Center
  • Gold Canyon, AZ
  • NPI 1245423219
  NPD Authorized official
• Advanced Foot & Ankle Specialists of Arizona PLLC

  • Podiatrist
  • Chandler, AZ
  • NPI 1962516674
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1801882006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 S KINGS RANCH RD",
            "address_2": "STE 6",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851182920",
            "telephone_number": "480-982-8137",
            "fax_number": "480-983-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9765 E DEAD SURE PL",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "852187176",
            "telephone_number": "480-363-3066",
            "fax_number": "480-983-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODMER",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "118594",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Audette, N.D.
• Az Whole Heart Connection, LLC
• Danielle Bailey
• Derek Bawden
• Kevin Bell, PA
• Jacob Mitchell Boehme, DPT
• Leanna Rae Bond, RDH
• Amber Bratcher, DPT
• Ryan Wade Brower, PA-C
• James Joseph Burnis, DIPL.AC., L.AC.

• Podiatrist in Gold Canyon, AZ
• Providers in Gold Canyon, AZ by specialty
• Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.