Individual provider Active NPI

Julie Mead Bogguss, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1205898764
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200461 Issued in NC
Practice address
6324 Fairview Rd
Suite 350
Charlotte, NC 28210-3271
Phone
(704) 384-8600
Fax
(704) 384-8610
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 200461 NC Primary

Addresses

Primary practice location

6324 Fairview Rd
Suite 350
Charlotte, NC 28210-3271

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-8600

Other identifiers 1

IdentifierTypeStateIssuer
7005350MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbogguss14530@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20170619000552 NC Practitioner - Nurse Practitioner 6002980059 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200461NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 1, 2017 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 1, 2017 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

6324 Fairview Rd
Ste 350
Charlotte, NC 28210
Phone (704) 384-8600

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

2400 South Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 316-3017

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1205898764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-8600",
            "fax_number": "704-384-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD",
            "address_2": "SUITE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103271",
            "telephone_number": "704-384-8600",
            "fax_number": "704-384-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGUSS",
        "first_name": "JULIE",
        "middle_name": "MEAD",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005350",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbogguss14530@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "6324 Fairview Rd",
            "address_2": "Suite 350",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282103271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.