Individual provider Active NPI

Robert Bauer, DO

  • Psychiatry Physician
  • Davidson, NC
National Provider Identifier
1437165669
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2020-01294 Issued in NC
Practice address
16740 Davidson Concord Rd
Davidson, NC 28036-8746
Phone
(704) 444-2400
NPI assigned
Jul 31, 2006
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2020-01294 NC Primary

Addresses

Primary practice location

16740 Davidson Concord Rd
Davidson, NC 28036-8746

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2301 US Highway 74 W
RM 1051
Wadesboro, NC 28170-7554
Phone (704) 694-4520

Other practice location 2

501 Billingsley Rd
Ste B
Charlotte, NC 28211-1009
Phone (704) 444-2400

Other practice location 3

706 W King St
Kings Mountain, NC 28086-2708
Phone (980) 487-5470

Other practice location 4

16740 Davidson Concord Rd
Ste 200
Davidson, NC 28036-8746
Phone (704) 801-9200

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rbauer407465@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910002842 NC Practitioner - Psychiatry 3971536194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

122 Gateway Blvd
Suite C
Mooresville, NC 28117-5544
Phone (704) 360-3637

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

7490 Waterside Crossing Blvd
Suite 2a
Denver, NC 28037-3004
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Asheli Thompson CurrentSince Aug 1, 2022 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Sep 14, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Sep 14, 2020 Accepting new patients
Physician Healthcare Network, PC Past Accepting new patients
Renewal Christian Counseling Center Inc PastSince Sep 19, 2011 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

501 Billingsley Rd
Ste B
Charlotte, NC 28211
Phone (704) 444-2400

16740 Davidson Concord Rd
Davidson, NC 28036
Phone (704) 444-2400

16740 Davidson Concord Rd
Ste 200
Davidson, NC 28036
Phone (704) 444-5881

706 W King St
Kings Mtn, NC 28086
Phone (704) 730-5108

122 Gateway Blvd
Ste C
Mooresville, NC 28117
Phone (980) 766-1030

2301 US Highway 74 W
Rm 1051
Wadesboro, NC 28170
Phone (704) 694-4520

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11357/brand/3/csg/1/fhir/r4
  • Direct secure messaging: lifestancehealth.robertbauer@146232.advancedmd-direct.com
  • Direct secure messaging: rbauer407465@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1437165669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16740 DAVIDSON CONCORD RD",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368746",
            "telephone_number": "704-444-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 US Highway 74 W",
            "address_2": "RM 1051",
            "address_purpose": "LOCATION",
            "city": "Wadesboro",
            "state": "NC",
            "postal_code": "281707554",
            "country_code": "US",
            "telephone_number": "704-694-4520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Billingsley Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111009",
            "country_code": "US",
            "telephone_number": "704-444-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "706 W King St",
            "address_purpose": "LOCATION",
            "city": "Kings Mountain",
            "state": "NC",
            "postal_code": "280862708",
            "country_code": "US",
            "telephone_number": "980-487-5470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16740 Davidson Concord Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280368746",
            "country_code": "US",
            "telephone_number": "704-801-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2020-01294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbauer407465@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "16740 Davidson Concord Rd",
            "city": "Davidson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280368746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.