Russ A. Bodner, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

9700480 Issued in NC

Practice address

315 Medical Park Dr
Ste 202
Concord, NC 28025-1902

Phone

(704) 403-1911

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Neurology

Education

Medical College of Pennsylvania, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
• Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
• Atrium Health University City Hospital, Charlotte, NC, CCN 340166

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rbodner417725@carolinashealthcaresystem.direct-ci.com

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.

• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment Care Compare group NPD
• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Monroe, NC
  • NPI 1821345919
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Neurology Physician
  • Concord, NC
  • NPI 1184051757
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Hematology & Oncology Physician
  • Charlotte, NC
  • NPI 1033489687
  NPD (past)

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

• Carolinas Medical Center

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1346297892
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Concord, NC
  • NPI 1487866315
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866
  Care Compare affiliation

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1639149693",
    "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": "315 MEDICAL PARK DR",
            "address_2": "STE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251902",
            "telephone_number": "704-403-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 5202",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 McAlister Rd",
            "address_2": "Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924126",
            "country_code": "US",
            "telephone_number": "980-212-6652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "923 N 2nd St",
            "address_2": "Ste 204",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013317",
            "country_code": "US",
            "telephone_number": "980-323-4475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Hospital Dr",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281126000",
            "country_code": "US",
            "telephone_number": "980-993-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNER",
        "first_name": "RUSS",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "9700480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbodner417725@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "315 Medical Park Dr",
            "address_2": "Ste 202",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydney Paige Boatman, PHARMD
• J. Daniel Bobbitt, M.D.
• Marisa Bocklet
• Wesley Winfield Bodie, DO
• Marlee Bodle, CRNA
• Tracy Lynn Boetto, FNP
• Michael Sean Boger, MD
• Bailey Nicole Boggs, OTD
• Alexander Vondra Boiwka, M.D.
• Lisa Bolumen, LPC, NCC

• Neurology Physician in Concord, NC
• Providers in Concord, NC by specialty
• Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.