Individual provider Active NPI

Bo Chigozie Nebolisa

  • Cardiovascular Disease Physician
  • Charlotte, NC
National Provider Identifier
1962906222
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2022-00677 Issued in NC
Practice address
1237 Harding Place
Suite 3100
Charlotte, NC 28204
Phone
(704) 373-0212
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2022-00677 NC
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 2022-00677 NC Primary

Addresses

Primary practice location

1237 Harding Place
Suite 3100
Charlotte, NC 28204

Mailing address

1237 Harding Place
Suite 3100
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 1

160 Dental Cir
Chapel Hill, NC 27599-2632
Phone (919) 966-5201

Other practice location 2

1430 Tulane Ave # Sl50
New Orleans, LA 70112-2632
Phone (540) 988-7809

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
I20231102004061 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1052643640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1237 Harding PL
Suite 3100
Charlotte, NC 28204-2826
Phone (704) 373-0212

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Cardiovascular Disease CurrentSince Aug 24, 2025 Accepting new patients
Carolinas Physicians Network Inc Cardiovascular Disease Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 24, 2025 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

1237 Harding Pl
Unit 2100
Charlotte, NC 28204
Phone (704) 468-3055

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

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

Interoperability endpoints

  • Direct secure messaging: bnebolisa106201@direct.unc.nchie.net
  • Direct secure messaging: bnebolisa3024995@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1962906222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 HARDING PLACE",
            "address_2": "SUITE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HARDING PLACE",
            "address_2": "SUITE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Dental Cir",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275992632",
            "country_code": "US",
            "telephone_number": "919-966-5201",
            "fax_number": "919-966-1743",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1430 Tulane Ave # Sl50",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "540-988-7809",
            "fax_number": "504-988-3971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEBOLISA",
        "first_name": "BO",
        "middle_name": "CHIGOZIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-08-05",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2022-00677",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2022-00677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.