Charles Andrew Bodenheimer, NP-C, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

236706 Issued in NC

Practice address

1200 N Elm St
Greensboro, NC 27401-1020

Phone

(336) 663-5025

Fax

(336) 663-5367

NPI assigned

Aug 29, 2018

Last updated

Aug 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

George Washington University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FCHR PAGroup PAC ID 9638121684, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• FCHR PA

  dba Four Corners Health & Rehabilitation

  • Physical Therapist
  • Clermont, FL
  • NPI 1760427975
  Care Compare group NPD
• Mobility Home Healthcare Inc

  • Home Health Agency
  • Clermont, FL
  • NPI 1669127981
  NPD (past)
• Theoria Medical

  dba Theoria Primary Care

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1043792880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011020",
            "telephone_number": "336-663-5025",
            "fax_number": "336-663-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011020",
            "telephone_number": "336-663-5025",
            "fax_number": "336-663-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHEIMER",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "credential": "NP-C, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "236706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie McNeely Boatwright, GNP
• Karen M. Flesner Bobalik, PT
• Bobbie L. Bingham, Ma, LPC, PLLC
• Fredric Jon Bobroff, MSW
• Marioara Cismas Bodea, M.D.
• Travis Corrow Bogan, LPC-A, NCC
• Derrick Boger
• Wendy Carisa Boger, RN
• Ariana Bogwicz, CNM
• Cherie Monet Bohaboy, LCSWA, CADCI

• Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.