Individual provider Active NPI

Alan Wayne Bozman, PH.D.

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1851324016
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2095 Issued in NC
Practice address
Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Phone
(704) 358-2700
Fax
(704) 358-2716
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2095 NC Primary

Addresses

Primary practice location

Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009

Mailing address

Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Phone (704) 358-2710

Other identifiers 1

IdentifierTypeStateIssuer
6000727MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2095NCMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Group-Psychiatric and Psychological Associates Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1851324016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "address_2": "501 BILLINGSLEY ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-358-2710",
            "fax_number": "704-358-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "address_2": "501 BILLINGSLEY ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-358-2700",
            "fax_number": "704-358-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZMAN",
        "first_name": "ALAN",
        "middle_name": "WAYNE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000727",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.