Heather Bodo, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN126074 Issued in OH

Practice address

2505 Edgewood Ave
Alliance, OH 44601-4613

Phone

(330) 418-4865

NPI assigned

Jun 15, 2011

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 15, 2011.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1922393271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 EDGEWOOD AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014613",
            "telephone_number": "330-418-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 EDGEWOOD AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014613",
            "telephone_number": "330-418-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODO",
        "first_name": "HEATHER",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN126074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Lee Bloom
• Christopher B Boatwright, PA
• Jessica Ann Bobby, L.S.W.
• Brittany Bober
• Adrian Bocciarelli
• Amber Nicole Borell
• Jill Borland, M.S., CF-SLP
• Peter Joseph Botti, LISW
• Jennifer L Bourne, CRNA
• Cindy L. Bower

• All providers in Alliance, OH
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.