Individual provider Active NPI

Richard Botelho, MD

  • Family Medicine Physician
  • Shelby, NC
National Provider Identifier
1508801374
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013-01565 Issued in NC
Practice address
708 McBrayer Homestead Rd
Shelby, NC 28152-9532
Phone
(980) 487-2090
NPI assigned
Jun 17, 2006
Last updated
Apr 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2013-01565 NC Primary

Addresses

Primary practice location

708 McBrayer Homestead Rd
Shelby, NC 28152-9532

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

3030 Randolph Rd
Ste 200
Charlotte, NC 28211-1368
Phone (704) 512-5000

Other practice location 2

201 Dale Earnhardt Blvd
Ste 200
Kannapolis, NC 28081-0308
Phone (704) 932-1155

Other practice location 3

3030 Randolph Rd
Ste 200
Charlotte, NC 28211-1368
Phone (704) 302-8200

Other practice location 4

16455 Statesville Rd
Ste 200
Huntersville, NC 28078-7135
Phone (704) 302-8600

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
I20151229000610 NC Practitioner - Family Practice 7911083977 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-01565NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 3, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 16, 2017 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jan 16, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Nov 18, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 3, 2019 Accepting new patients

Locations

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

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

3030 Randolph Rd
Ste 200
Charlotte, NC 28211
Phone (704) 302-8200

4525 Cameron Valley Pkwy
Ste 3100
Charlotte, NC 28211
Phone (704) 302-8375

8840 Blakeney Professional Dr
Ste 100
Charlotte, NC 28277
Phone (704) 667-2340

9908 Couloak Dr
Ste 202
Charlotte, NC 28216
Phone (704) 801-3050

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

707 Memorial Blvd
Concord, NC 28025
Phone (704) 403-7050

16455 Statesville Rd
Ste 200
Huntersville, NC 28078
Phone (704) 302-8600

201 Dale Earnhardt Blvd
Ste 200
Kannapolis, NC 28081
Phone (704) 403-7300

3970 W Highway 27
Lincolnton, NC 28092
Phone (704) 748-2245

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

215 S Main St
Mt Holly, NC 28120
Phone (704) 393-4808

708 McBrayer Homestead Rd
Shelby, NC 28152
Phone (704) 434-8123

4429 W Highway 27
Vale, NC 28168
Phone (704) 748-2245

Organizations & group practices 8

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1508801374",
    "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": "708 MCBRAYER HOMESTEAD RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281529532",
            "telephone_number": "980-487-2090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Randolph Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111368",
            "country_code": "US",
            "telephone_number": "704-512-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Dale Earnhardt Blvd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kannapolis",
            "state": "NC",
            "postal_code": "280810308",
            "country_code": "US",
            "telephone_number": "704-932-1155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3030 Randolph Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111368",
            "country_code": "US",
            "telephone_number": "704-302-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "704-302-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTELHO",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-01565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.