Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Amanda Bodine, PA

Individual provider Medical Physician Assistant · NPI 1770853772

Amanda Bodine, PA is a Physician Assistant in Edmond, Oklahoma. Qualified in 2011, 15 years ago. Practices with Edmond Primary Care LLC, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma.

Years since qualifying
15
Licensed in
OK
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

200 N Bryant Ave Ste 105
Edmond, OK 73034-6273
Phone: (405) 300-8964
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2060 (OK)

Record details

NPI number1770853772
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 6, 2012
Last updated in NPPESJuly 18, 2025
Certification dateJuly 18, 2025
Mailing address200 N Bryant Ave Ste 105, Edmond, OK 73034-6273

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Edmond Primary Care Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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