Individual provider Active NPI

Jennifer Lynn Bodley, O.D.

  • Optometrist
  • Tucson, AZ
National Provider Identifier
1982622643
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1829 Issued in AZ
Practice address
9615 E Old Spanish TRL
Tucson, AZ 85748-7540
Phone
(520) 546-1766
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1829 AZ Primary

Addresses

Primary practice location

9615 E Old Spanish TRL
Tucson, AZ 85748-7540

Mailing address

8104 N Wayward Star Dr
Tucson, AZ 85743-7354
Phone (325) 245-7626

Other practice location 1

3699 E Broadway Blvd
Tucson, AZ 85716-5400
Phone (520) 917-0163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1829AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
You and Eye Care, PLLC Current Accepting new patients

Locations

3699 E Broadway Blvd
Tucson, AZ 85716
Phone (520) 917-0117

9615 E Old Spanish Trl
Tucson, AZ 85748
Phone (520) 296-3775

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1982622643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8104 N WAYWARD STAR DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857437354",
            "telephone_number": "325-245-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 E OLD SPANISH TRL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857487540",
            "telephone_number": "520-546-1766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3699 E Broadway Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857165400",
            "country_code": "US",
            "telephone_number": "520-917-0163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODLEY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.