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BROCK BODILY
NPI 1366004517
Physician Assistant - Surgical in South Jordan, UT

Active since July 08, 2019
10623 S REDWOOD RD # 101, SOUTH JORDAN, UT 84095(801) 566-4242 Get Directions Write a Review

NPPES record last updated: July 8, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brock Bodily NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROCK BODILY (NPI 1366004517) is an individual surgical provider in South Jordan, Utah, licensed in Utah (11353289-8002) and active in the NPI registry since July 2019.

NPPES Registry Identity

NPI1366004517
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameBROCK BODILY
Location Address10623 S REDWOOD RD # 101South Jordan, UT 84095-2481
Mailing Address1265 N 850 EPleasant Grove, UT 84062-1998
Phone(801) 566-4242
Sole ProprietorNo
Enumeration DateJuly 8, 2019
✔ NPI 1366004517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in UT · 11353289-8002
10623 S REDWOOD RD # 101, South Jordan, UT 84095
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brock Bodily's NPI number?

The NPI number for Brock Bodily is 1366004517. It was assigned to this individual provider in the NPPES registry on July 8, 2019.

Where is Brock Bodily located?

Brock Bodily practices at 10623 S Redwood Rd # 101, South Jordan, UT 84095. The listed phone number is (801) 566-4242.

What is Brock Bodily's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Brock Bodily was last updated on July 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.