NPIMap

Organization Active NPI

Gregory T Bodrie OD

  • Durable Medical Equipment & Medical Supplies
  • Sagamore, MA
National Provider Identifier
1992973986
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
2646 Issued in MA
Legal business name
GREGORY T BODRIE OD
Practice address
66 Pleasant St.
Sagamore, MA 02561-0532
Phone
(508) 888-2020
Fax
(508) 888-4423
NPI assigned
Feb 13, 2008
Last updated
Jun 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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

Authorized official

Name
Dr. Gregory Taylor Bodrie, ODNPI 1164493979
Title
Owner
Phone
(508) 888-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2646 MA Primary

Addresses

Primary practice location

66 Pleasant St.
Sagamore, MA 02561-0532

Mailing address

PO Box 532
66 Pleasant Street
Sagamore, MA 02561-0532
Phone (508) 888-2020

Other identifiers 2

IdentifierTypeStateIssuer
0332003MedicaidMA
W15268OtherMABLUE CROSS / BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245974400000",
    "number": "1992973986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532",
            "address_2": "66 PLEASANT STREET",
            "city": "SAGAMORE",
            "state": "MA",
            "postal_code": "025610532",
            "telephone_number": "508-888-2020",
            "fax_number": "508-888-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 PLEASANT ST.",
            "city": "SAGAMORE",
            "state": "MA",
            "postal_code": "025610532",
            "telephone_number": "508-888-2020",
            "fax_number": "508-888-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY T BODRIE OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2009-06-26",
        "status": "A",
        "authorized_official_last_name": "BODRIE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-888-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "2646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332003",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "W15268",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sagamore, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; 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.