Individual provider Active NPI

Christina Marie Dodge, NP-C

  • Nurse Practitioner
  • Mocksville, NC
National Provider Identifier
1376971259
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5006563 Issued in NC
Practice address
485 Valley Rd
Mocksville, NC 27028-2074
Phone
(336) 751-8000
Fax
(336) 751-8010
NPI assigned
Oct 31, 2013
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5006563 NC
Nurse Practitioner 363L00000X 5006563 NC Primary

Addresses

Primary practice location

485 Valley Rd
Mocksville, NC 27028-2074

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other practice location 1

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 384-5416

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdodge115831@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
I20140403002333 NC Practitioner - Nurse Practitioner 8325270465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

485 Valley Rd
Mocksville, NC 27028-2074
Phone (336) 751-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince Mar 21, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Mar 21, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

485 Valley Rd
Mocksville, NC 27028
Phone (336) 751-8000

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

Interoperability endpoints

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

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "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": []
}

Other providers in Mocksville, NC

Sources for this page

Verify at the official NPI Registry.