Individual provider Active NPI

Carlos Ramon Bolden, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1437500329
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008649 Issued in NC
Practice address
7810 Providence Rd
Ste 102
Charlotte, NC 28226-2954
Phone
(704) 543-6636
NPI assigned
Jun 22, 2016
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5008649 NC
Family Nurse Practitioner 363LF0000X 5008649 NC Primary

Addresses

Primary practice location

7810 Providence Rd
Ste 102
Charlotte, NC 28226-2954

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

332 N Trade St
Ste 1100
Matthews, NC 28105-1728
Phone (704) 512-6850

Other practice location 2

10210 Couloak Dr
Ste E
Charlotte, NC 28216-7679
Phone (704) 801-2000

Other practice location 3

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

Other practice location 4

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269-2206
Phone (704) 863-9930

Other practice location 5

9600 E Independence Blvd Ste B
Matthews, NC 28105-4628
Phone (704) 815-5624

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cbolden499929@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160928002600 NC Practitioner - Nurse Practitioner 1557658937 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

14214 Ballantyne Lake Rd
Suite 100
Charlotte, NC 28277-3373
Phone (704) 667-2650

9600 E Independence Blvd
Suite B
Matthews, NC 28105-4628
Phone (704) 815-5624

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008649NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Sep 10, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 10, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Arboretum Urgent Care Center CurrentSince Sep 10, 2018 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 18, 2024 Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

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

703 Leonard Ave
Albemarle, NC 28001
Phone (704) 550-0050

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

10210 Couloak Dr
Ste E
Charlotte, NC 28216
Phone (704) 801-2000

11115 Golf Links Dr
Ste B
Charlotte, NC 28277
Phone (704) 667-0080

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269
Phone (704) 863-9930

7810 Providence Rd
Ste 102
Charlotte, NC 28226
Phone (704) 393-4808

8036 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (980) 301-8711

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

332 N Trade St
Ste 1100
Matthews, NC 28105
Phone (704) 512-6850

9600 E Independence Blvd
#B
Matthews, NC 28105
Phone (704) 815-5624

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: cbolden499929@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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1437500329",
    "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": "7810 PROVIDENCE RD",
            "address_2": "STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282262954",
            "telephone_number": "704-543-6636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 N Trade St",
            "address_2": "Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281051728",
            "country_code": "US",
            "telephone_number": "704-512-6850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10210 Couloak Dr",
            "address_2": "Ste E",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167679",
            "country_code": "US",
            "telephone_number": "704-801-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5717 Albemarle Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282121634",
            "country_code": "US",
            "telephone_number": "704-563-2150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5727 Prosperity Crossing Dr",
            "address_2": "Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692206",
            "country_code": "US",
            "telephone_number": "704-863-9930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9600 E Independence Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281054628",
            "country_code": "US",
            "telephone_number": "704-815-5624",
            "fax_number": "704-815-5621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "CARLOS",
        "middle_name": "RAMON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008649",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbolden499929@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 102",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282262954",
            "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 Charlotte, NC

Sources for this page

Verify at the official NPI Registry.