Individual provider Active NPI

Shannon Moffitt Bomstein, AUD

  • Audiologist
  • Durham, NC
National Provider Identifier
1881323764
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
14977 Issued in NC
Practice address
4102 N Roxboro St
Durham, NC 27704-2122
Phone
(919) 595-2000
NPI assigned
Jun 7, 2022
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 14977 NC Primary

Addresses

Primary practice location

4102 N Roxboro St
Durham, NC 27704-2122

Mailing address

4102 N Roxboro St
Durham, NC 27704-2122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721001947 NC Practitioner - Qualified Audiologist 0547641581 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

40 Duke Medicine Cir
Durham, NC 27710-3810
Phone (919) 684-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 27, 2025 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 27, 2025 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 27, 2025 Accepting new patients
North Carolina Eye Ear Nose & Throat PA PastSince Jun 16, 2006 Accepting new patients

Locations

1010 Tryon Village Dr
#701
Cary, NC 27518

1838 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-7278

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

4102 N Roxboro St
Durham, NC 27704
Phone (919) 595-2000

5726 Fayetteville Rd
Ste 102
Durham, NC 27713
Phone (919) 682-9341

Organizations & group practices 5

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": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1881323764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-595-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMSTEIN",
        "first_name": "SHANNON",
        "middle_name": "MOFFITT",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "14977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.