DR. KENNETH E BODEK


Address: 186 Kimel Park Dr, Suite 400, Winston Salem, NC 27103-6946
Phone: 3362772000

DR. KENNETH E BODEK (NPI# 1871587923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871587923
Entity Type Individual
Full Name DR. KENNETH E BODEK
Credential M.D.
Practice Address 186 Kimel Park Dr
Suite 400
Winston Salem
NC 27103-6946
Mailing Address Po Box 751803
Suite 400
Charlotte
NC 28275-1803
Practice Telephone 3362772000
Practice Fax Number 3362772050
Mailing Telephone 3362772000
Mailing Fax Number 3362772050
Enumeration Date 2005-09-06
Last Update Date 2020-10-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
2013-01642 NC Allopathic & Osteopathic Physicians
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
MD046703L PA Allopathic & Osteopathic Physicians
N 207UN0901X Nuclear Medicine
Specialization: Nuclear Cardiology
MD046703L PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA MEDICARE 024733E15 01
PA 0012804190005 05

Office Location

Street Address 186 KIMEL PARK DR
SUITE 400
City WINSTON SALEM
State NC
Zip Code 27103-6946

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851940753 Casey Leigh Hardy Nurse Practitioner 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2019-09-04
1881248029 Ennie Austin Nurse Practitioner 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2019-07-26
1972023737 Francis Wingate Hayes Iv Nurse Practitioner 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2017-06-22
1255786273 Nathan Mcgeathy Nurse Practitioner 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2016-04-27
1376925214 Joseph Mintz Physician Assistant 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2015-06-27
1679961353 Michelle Swaim Nurse Practitioner 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2015-01-02
1508107707 Jennifer Doby Davis Nurse Practitioner 186 Kimel Park Dr, Winston Salem, NC 27103-6946 2013-03-13
1255682415 Dawn Marie Delo O'reilly Physician Assistant 186 Kimel Park Dr, Winston Salem, NC 27103 2012-09-27
1639431307 Bradley Walton Clark Internal Medicine 186 Kimel Park Dr, Winston Salem, NC 27103 2012-06-08
1285994426 Pallavi Sharma Gomadam Internal Medicine 186 Kimel Park Dr, Winston Salem, NC 27103 2012-05-22
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124648126 Kelly Anne Wales Pharmacist 3917-a Westpoint Boulevard, Winston-salem, NC 27103 2020-04-20
1386281533 Elena Mcginty Nurse Practitioner 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 2019-12-06
1992359442 Madeline Pryor Pharmacist 255 Charlois Drive, Winston Salem, NC 27103 2019-08-01
1215599584 Palmetto Oxygen LLC Durable Medical Equipment & Medical Supplies 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 2019-07-07
1548734718 Trivy Johnson Specialist 1384-b Westgate Center Dr., Winston Salem, NC 27103 2019-01-21
1447745047 Novant Health Rehabilitation Hospital of Winston-salem, LLC Rehabilitation Hospital 2475 Hillcrest Center Circle, Winston Salem, NC 27103 2018-06-26
1346740206 Joseph Miller Physical Therapist 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 2018-02-17
1548779101 Kristin Blow Counselor 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 2017-09-27
1891213443 Alisha Dawn Wilson Occupational Therapy Assistant 2101 Homestead Hills Drive, Winston Salem, NC 27103 2017-09-05
1588186969 Brandy Wilson Social Worker 153 Cameron Way Circle, Winston Salem, NC 27103 2017-07-07
Find all providers in zip 27103

Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013194471 Zahid A. Junagadhwalla Internal Medicine 2150 Country Club Rd, Winston Salem, NC 27104-4241 2008-01-29
1013127299 Amer I Aladin Internal Medicine Medical Center Boulevard Department of Cardiology, Winston Salem, NC 27157-1045 2007-05-23
1366493751 Barbara A Pisani Internal Medicine Medical Ctr, Winston Salem, NC 27157-0001 2006-05-12
1245288786 Forsyth Medical Group, LLC Internal Medicine 2000 Frontis Plaza Blvd Ste 102, Winston Salem, NC 27103-5616 2006-05-05
1497739189 Bt Heart and Vascular Center, Pllc Internal Medicine 150 Charlois Blvd, Suite 223, Winston Salem, NC 27103-1549 2005-12-06
1376195669 Chloe Erin Decklever Internal Medicine Medical Center Blvd, Winston Salem, NC 27157-0001 2019-07-16
1619529351 Matthew Tyler Watson Internal Medicine Medical Center Blvd, Winston Salem, NC 27157-0001 2019-07-12
1285298190 Hannah Marie Mccallum Internal Medicine Medical Center Boulevard, Winston Salem, NC 27157-0001 2019-04-25
1861913600 Jade Mccormick Kiger Internal Medicine Medical Center Blvd, Winston Salem, NC 27157-8708 2017-07-02
1568828903 Regional Physicians LLC Internal Medicine 3333 Brookview Hills Blvd, Winston Salem, NC 27103 2016-01-14
Find all providers in WINSTON SALEM

Competitor

Search similar providers

City WINSTON SALEM
Zip Code 27103

Improve Information

Please comment or provide details below to improve the information on DR. KENNETH E BODEK.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches