James Boddy

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

242441 Issued in WI

Practice address

2851 University Ave
Green Bay, WI 54311-5855

Phone

(920) 431-2500

NPI assigned

Jun 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Recovia LLC

  • Specialist
  • Phoenix, AZ
  • NPI 1427421098
  Medicare reassignment NPD
• Ageless Nutrition Bar Holdings, Inc

  • Adult Medicine Physician
  • Phoenix, AZ
  • NPI 1932704830
  NPD (past)
• Recovia LLC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
  • NPI 1386313864
  NPD (past)
• Recovia LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Phoenix, AZ
  • NPI 1568139616

  Registered Nurse

  NPD (past)

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1891310827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 UNIVERSITY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 UNIVERSITY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115855",
            "telephone_number": "920-431-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODDY",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "F06201277",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "242441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.boddy@va.gov",
            "affiliation": "N",
            "address_1": "2851 University Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543115855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas Edward Bobka, OD
• Megan Bocchicchio
• Martin Bochenek, MD
• Mark W Bocik, CRNA
• Michael Bodart, PT
• Sara Lea Bodem, PHYSICAL THERAPIST
• Body & Soul MFR Therapy LLC
• Amanda Lee Boeckman
• Nicholas Michael Boege, PHARMD
• Brandon E Boehm, MD

• Registered Nurse in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.