Christina Marie Dodge, NP-C

Key facts

NPI

1376971259

Entity type

Individual (NPI type 1)

Primary specialty

Nurse Practitioner 363L00000X

License

5006563 (NC)

Practice address

485 Valley Rd
Mocksville, NC 27028-2074

Phone

(336) 751-8000

Fax

(336) 751-8010

NPI assigned

Oct 31, 2013

Sex

Female

Sole proprietor

No

Organizations & group practices 4

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.

• Forsyth Memorial Hospital, Inc. Family Medicine Physician · Winston Salem, NC · NPI 1104548874
  Medicare reassignment Care Compare group NPD NC
• Forsyth Memorial Hospital, Inc. General Acute Care Hospital · Winston Salem, NC · NPI 1447200233
  Care Compare group
• Forsyth Memorial Hospital, Inc. Cardiovascular Disease Physician · Winston Salem, NC · NPI 1932935475
  NPD
• Forsyth Memorial Hospital, Inc Family Medicine Physician · Mount Airy, NC · NPI 1295783108
  NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc. General Acute Care Hospital · Winston Salem, NC · NPI 1447200233
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital Inc (622 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital · Winston-Salem, NC · CCN 340014

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdodge115831@direct.novanthealth.org

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 10, 2024.

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1376971259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 VALLEY RD",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282074",
            "telephone_number": "336-751-8000",
            "fax_number": "336-751-8010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10030 Gilead Rd",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787545",
            "country_code": "US",
            "telephone_number": "704-384-5416",
            "fax_number": "704-384-5992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODGE",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006563",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdodge115831@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10030 Gilead Rd",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in Mocksville, NC · Nurse Practitioner in North Carolina