Nicholas Barrett Bodenheimer, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

201500279 Issued in NC

Practice address

584 Hospital Drive
Suite B
Bolivia, NC 28422-9047

Phone

(910) 721-4050

Fax

(910) 721-4051

NPI assigned

Apr 28, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Obstetrics/Gynecology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group LLC

  • Obstetrics & Gynecology Physician
  • Bolivia, NC
  • NPI 1205884970
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Mooresville, NC
  • NPI 1487012886
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

• Brunswick Community Hospital, LLC

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  Care Compare affiliation
• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1457642134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "910-721-4050",
            "fax_number": "910-721-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 HOSPITAL DRIVE",
            "address_2": "SUITE B",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284229047",
            "telephone_number": "910-721-4050",
            "fax_number": "910-721-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHEIMER",
        "first_name": "NICHOLAS",
        "middle_name": "BARRETT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "201500279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbodenheimer245810@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "584 Hospital Drive",
            "address_2": "Suite B",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284229047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hussain Khuzem Bhagat
• Chandana Bhimmanapalli, MD
• Nicholas Proch Billings, DO
• Blissful Beginnings Therapy Group PLLC
• Alan Joseph Bloszko Jr, MD
• Sampson Ray Booth, PA-C
• Roberta Samelson Bracken, M.D.
• Heather C Braithwaite, MD
• Christopher Adams Brann, MD
• Justin Bridge

• Obstetrics & Gynecology Physician in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.