DR. JACQUELYNE R BODEA (PMHNP-BC, CNM) – Psychiatric/Mental Health Nurse Practitioner, NPI 1225100118
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JACQUELYNE R BODEA (PMHNP-BC, CNM)
100 STONEFOREST DR STE 230
WOODSTOCK, GA 301894903
Phone: (470) 552-8470
Type: Location
34 LOBO TRL
MORGANTON, GA 305602685
Phone: (706) 817-6966
Type: Mailing
Maniilaq Medical Center, 436, 5th Avenue, Kotzebue, Northwest Arctic, Alaska, 99752, United States
KOTZEBUE, AK 99752
Phone: (907) 442-3321
Type: Location
10025 INVESTMENT DR STE 100
KNOXVILLE, TN 379322665
Phone: (865) 606-6110
Fax: (865) 312-6442
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-05-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20091109000553 | I | Certified Nurse Midwife (Cnm) | GA | TBD |
| I20160914000627 | I | Certified Nurse Midwife (Cnm) | TX | TBD |
| I20220525000233 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30189)
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