Individual provider Active NPI

Joy Bodwell, O.D.

  • Optometrist
  • Olympia, WA
National Provider Identifier
1992112197
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60587417 Issued in WA
Practice address
406 Lilly Rd NE
Suite a
Olympia, WA 98506-5118
Phone
(360) 491-2121
NPI assigned
Jul 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60587417 WA Primary

Addresses

Primary practice location

406 Lilly Rd NE
Suite a
Olympia, WA 98506-5118

Mailing address

406 Lilly Rd NE
Suite a
Olympia, WA 98506-5118
Phone (360) 491-2121

Other names 1

  • Joy Zurek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140923000345 TX Practitioner - Optometry 6507085669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3584TNMDChiropractor
60587417WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
20 20 Icare, PLLC Optometrist PastSince Oct 1, 2019 Accepting new patients

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": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1992112197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LILLY RD NE",
            "address_2": "SUITE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065118",
            "telephone_number": "360-491-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 LILLY RD NE",
            "address_2": "SUITE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065118",
            "telephone_number": "360-491-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODWELL",
        "first_name": "JOY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-20",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60587417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "ZUREK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.