Individual provider Active NPI

Mercedes Suzanne Hodges, FNP-C

  • Family Nurse Practitioner
  • Concord, NC
National Provider Identifier
1386409688
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5019628 Issued in NC
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 403-1082
Fax
(704) 403-4575
NPI assigned
Feb 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5019628 NC Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

920 Church St N
Concord, NC 28025-2927

Other practice location 1

131 Welton Way
Mooresville, NC 28117-9163
Phone (704) 360-4564

Other practice location 2

440 Jake Alexander Blvd W
Salisbury, NC 28147-1365
Phone (704) 360-4564

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
I20240228000960 NC Practitioner - Nurse Practitioner 9739524976 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5019628NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Pain and Weight Loss Nurse Practitioner CurrentSince Feb 20, 2024 Accepting new patients
Carolina Pain and Weight Loss, PA Nurse Practitioner CurrentSince Feb 20, 2024 Accepting new patients

Locations

131 Welton Way
Mooresville, NC 28117
Phone (704) 360-4564

440 Jake Alexander Blvd W
Salisbury, NC 28147
Phone (704) 360-4564

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGICCA
  • Direct secure messaging: mhodges407949@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1386409688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "fax_number": "704-403-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1082",
            "fax_number": "704-403-4575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Welton Way",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179163",
            "country_code": "US",
            "telephone_number": "704-360-4564",
            "fax_number": "704-360-4553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Jake Alexander Blvd W",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281471365",
            "country_code": "US",
            "telephone_number": "704-360-4564",
            "fax_number": "704-360-4553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGES",
        "first_name": "MERCEDES",
        "middle_name": "SUZANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.