NPIMap

Individual provider Active NPI

David J Bohle, MD

  • Cardiovascular Disease Physician
  • Elkin, NC
National Provider Identifier
1710966718
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35270 Issued in NC
Practice address
100 Johnson Ridge Medical Park
Elkin, NC 28621-2400
Phone
(336) 716-2255
NPI assigned
Jan 10, 2006
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35270 NC Primary
Interventional Cardiology Physician 207RI0011X 35270 NC

Addresses

Primary practice location

100 Johnson Ridge Medical Park
Elkin, NC 28621-2400

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-2000

Other practice location 1

186 Kimel Park Dr
Winston-Salem, NC 27103-6946
Phone (336) 277-2000

Other identifiers 5

IdentifierTypeStateIssuer
1285682310OtherNCWSCA GRP NPI #
1710966718MedicaidVA
16435OtherNCBCBS ID#
10533OtherNCPARTNERS ID#
8916435MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040716000449 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 0840279485 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Medical School at San Antonio, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35270NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2019 Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Northern Hospital of Surry County Current Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Dec 31, 1996 Accepting new patients
Forsyth Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Dec 31, 1996 Accepting new patients

Locations

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

100 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 245-2100

600 Chatham Medical Park
Elkin, NC 28621
Phone (336) 527-7000

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

216 Moore Rd
King, NC 27021
Phone (336) 768-1270

250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150

903 Randolph St
Thomasville, NC 27360
Phone (336) 475-7163

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: dbohle2754302@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1710966718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JOHNSON RIDGE MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212400",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Kimel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHLE",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "35270",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "35270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WSCA GRP NPI #",
            "identifier": "1285682310",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710966718",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "16435",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS ID#",
            "identifier": "10533",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8916435",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.