Charles Douglas Bodine Jr., M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

88983 Issued in GA

Practice address

3320 Old Jefferson Rd BLDG 700
Athens, GA 30607-1465

Phone

(706) 353-2990

Fax

(706) 353-2992

NPI assigned

May 21, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Hematology/Oncology

Education

Mercer University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Cancer and Blood Center LLCGroup PAC ID 0345293866, 66 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074
• St Mary'S Hospital Hospital, Athens, GA, CCN 110006

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• University Cancer & Blood Center LLC

  • Hematology & Oncology Physician
  • Athens, GA
  • NPI 1346343761

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation
• St. Mary'S Hospital, Inc.

  dba St. Mary's Hospital

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1871556621
  Care Compare affiliation

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1740669928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 700",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071465",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Old Jefferson Rd Bldg 300",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071400",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Mercer Pl",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "GA",
            "postal_code": "305291552",
            "country_code": "US",
            "telephone_number": "706-510-1437",
            "fax_number": "706-778-6270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3320 Old Jefferson Rd Bldg 800",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071400",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1460 Resurgence Dr",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777320",
            "country_code": "US",
            "telephone_number": "706-715-2410",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODINE",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "88983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003251625A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Board of Regents of the University System of Georgia (The University of Georgia)
• Board of Regents of the University System of Georgia (University of Georgia College of Pharmacy)
• Board of Regents of the University System of Georgia (University Health Center, University of Georgia)
• Board of Regents of the University System of Georgia (Center for Autism and Behavioral Education Research)
• Beth M Boatman, LPC
• Cheran Bodry, LCSW
• Robyn Simone Boggs, EFDA
• Ashley Marie Bohn, DO
• Bok Bok Therapy, LLC
• Meredith Jennifer Bolton, M.D.

• Hematology & Oncology Physician in Athens, GA
• Providers in Athens, GA by specialty
• Hematology & Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.