Individual provider Active NPI

Daniel Joseph Bonthius, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
National Provider Identifier
1962497321
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
2019-01232 Issued in NC
Practice address
1001 Blythe Blvd
Charlotte, NC 28203-5866
Phone
(704) 381-1450
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2019-01232 NC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2019-01232 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Charlotte, NC 28203-5866

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

6600 W Wilkinson Blvd
Belmont, NC 28012-2796
Phone (704) 381-1450

Other practice location 2

9625 Northcross Center Ct
Ste 102B
Huntersville, NC 28078-7348
Phone (704) 801-1240

Other practice location 3

100 Medical Park Dr
Suite 310
Concord, NC 28025-2948
Phone (704) 403-2660

Other practice location 4

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866
Phone (704) 373-1813

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address dbonthius426969@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210218001282 NC Practitioner - Pediatric Medicine 2567556004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

1001 Blythe Blvd
Charlotte, NC 28203-5866
Phone (704) 381-1450

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-01232NCMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc. CurrentSince Dec 27, 2020 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Neurology With Special Qualifications in Child Neurology CurrentSince Apr 24, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Apr 24, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 9, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 27, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

2608 E 7th St
Charlotte, NC 28204
Phone (704) 344-9034

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

100 Medical Park Dr
Ste 310
Concord, NC 28025
Phone (704) 403-2860

9625 Northcross Center Ct
Ste 102B
Huntersville, NC 28078
Phone (704) 801-1240

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: dbonthius426969@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1962497321",
    "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": "1001 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-1450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 W Wilkinson Blvd",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280122796",
            "country_code": "US",
            "telephone_number": "704-381-1450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9625 Northcross Center Ct",
            "address_2": "Ste 102B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787348",
            "country_code": "US",
            "telephone_number": "704-801-1240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-2660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-373-1813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONTHIUS",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2019-01232",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "2019-01232",
            "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": "dbonthius426969@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1001 Blythe Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.