Heather Monk Bodenstab, PHARM.D.

Primary specialty

Pediatric PharmacistTaxonomy code 1835P0200X

License

28RI04239800 Issued in NJ

Practice address

111 Horseshoe LN
Pottstown, PA 19465-8506

Phone

(267) 761-1617

NPI assigned

May 17, 2023

Last updated

May 17, 2023By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1841981255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HORSESHOE LN",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194658506",
            "telephone_number": "267-761-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HORSESHOE LN",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194658506",
            "telephone_number": "267-761-1617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Laurel Oak Rd",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434310",
            "country_code": "US",
            "telephone_number": "888-873-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODENSTAB",
        "first_name": "HEATHER",
        "middle_name": "MONK",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "PA",
            "license": "RP440984",
            "primary": false
        },
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "NJ",
            "license": "28RI04239800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Pharmacist in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Pediatric Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.