NMG AFFILIATE PRACTICE I LLC


Address: 150 Charlois Blvd, Suite 290, Winston Salem, NC 27103-1549
Phone: 3367652500

NMG AFFILIATE PRACTICE I LLC (NPI# 1114222700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114222700
Entity Type Organization
Organization Name NMG AFFILIATE PRACTICE I LLC
Other Organization Name NOVANT HEALTH PIEDMONT VEIN
Practice Address 150 Charlois Blvd
Suite 290
Winston Salem
NC 27103-1549
Mailing Address Po Box 602362
Charlotte
NC 28260-2362
Practice Telephone 3367652500
Practice Fax Number 3367652555
Mailing Telephone 7043847840
Mailing Fax Number 7043847830
Enumeration Date 2011-01-13
Last Update Date 2013-06-21
Authorized Official Name GEOFFREY K GARDNER (VP OF FINANCE)
Authorized Official Telephone 3367652500
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Novant Health Piedmont Vein Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1750719977 Nmg Affiliate Practice I LLC Internal Medicine 10945 George Mason Cir, Manassas, VA 20110-2233 2013-10-25
1639474240 Nmg Affiliate Practice I LLC Internal Medicine 812 West Stuart Drive, Galax, VA 24333-2605 2011-01-13
1801191317 Nmg Affiliate Practice I LLC Internal Medicine 110 East Blue Ridge Street, Stuart, VA 24171 2011-01-13
1407211451 Nmg Affiliate Practice I LLC Family Medicine 15225 Heathcote Blvd, Haymarket, VA 20169-6264 2015-12-17
1861857815 Nmg Affiliate Practice I LLC Family Medicine 8700 Sudley Rd, Manassas, VA 20110-4418 2015-12-17
1457741126 Nmg Affiliate Practice I LLC Internal Medicine 8575 Sudley Rd, Suite A, Manassas, VA 20110-3861 2015-02-02
1386053502 Nmg Affiliate Practice I LLC Psychiatry & Neurology 8644 Sudley Rd, Suite 315, Manassas, VA 20110-4417 2014-08-13
1558666164 Nmg Affiliate Practice I LLC Internal Medicine 150 Charlois Blvd, Suite 100, Winston Salem, NC 27103-1549 2011-01-13
1184929796 Nmg Affiliate Practice I LLC Internal Medicine 694 Riverside Dr, Mount Airy, NC 27030-3117 2011-01-13

Other Data Sources

Entity Type Entity Name Entity Address
Virginia Business Entities NMG AFFILIATE PRACTICE I LLC 200 Hawthorne Ln, Charlotte, North Carolina 28204
North Carolina Corporations NMG Affiliate Practice I LLC 2085 Frontis Plaza Blvd, Winston Salem, NC 27103-5614

Office Location

Street Address 150 CHARLOIS BLVD
SUITE 290
City WINSTON SALEM
State NC
Zip Code 27103-1549

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497739189 Bt Heart and Vascular Center, Pllc Internal Medicine 150 Charlois Blvd, Suite 223, Winston Salem, NC 27103-1549 2005-12-06
1740735331 Cnc / Access, Inc. Home Health 150 Charlois Blvd, Winston Salem, NC 27103-1549 2016-08-24
1245638477 Novant Medical Group, Inc. Advanced Practice Midwife 150 Charlois Blvd, Suite 100, Winston Salem, NC 27103-1549 2014-12-22
1609201748 Megan Peabody Hulen Nurse Practitioner 150 Charlois Blvd, Winston Salem, NC 27103-1549 2013-09-09
1396013462 Key Behavior Essentials L.l.c Counselor 150 Charlois Blvd, Suite 350, Winston Salem, NC 27103-1549 2011-12-05
1558666164 Nmg Affiliate Practice I LLC Internal Medicine 150 Charlois Blvd, Suite 100, Winston Salem, NC 27103-1549 2011-01-13
1285864991 Michael James Davanzo Physician Assistant 150 Charlois Blvd, Suite 100, Winston Salem, NC 27103-1549 2009-07-16
1871736694 Cnc / Access, Inc. Community/Behavioral Health 150 Charlois Blvd, Winston Salem, NC 27103-1549 2009-04-09
1376789792 Amy Howell Wren Advanced Practice Midwife 150 Charlois Blvd, Suite 100, Winston Salem, NC 27103-1549 2009-01-07
1629031844 Elke Bachmann Registered Nurse 150 Charlois Blvd, Suite 100, Winston Salem, NC 27103-1549 2006-04-10
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124648126 Kelly Anne Wales Pharmacist 3917-a Westpoint Boulevard, Winston-salem, NC 27103 2020-04-20
1386281533 Elena Mcginty Nurse Practitioner 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 2019-12-06
1992359442 Madeline Pryor Pharmacist 255 Charlois Drive, Winston Salem, NC 27103 2019-08-01
1215599584 Palmetto Oxygen LLC Durable Medical Equipment & Medical Supplies 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 2019-07-07
1548734718 Trivy Johnson Specialist 1384-b Westgate Center Dr., Winston Salem, NC 27103 2019-01-21
1447745047 Novant Health Rehabilitation Hospital of Winston-salem, LLC Rehabilitation Hospital 2475 Hillcrest Center Circle, Winston Salem, NC 27103 2018-06-26
1346740206 Joseph Miller Physical Therapist 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 2018-02-17
1548779101 Kristin Blow Counselor 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 2017-09-27
1891213443 Alisha Dawn Wilson Occupational Therapy Assistant 2101 Homestead Hills Drive, Winston Salem, NC 27103 2017-09-05
1588186969 Brandy Wilson Social Worker 153 Cameron Way Circle, Winston Salem, NC 27103 2017-07-07
Find all providers in zip 27103

Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013194471 Zahid A. Junagadhwalla Internal Medicine 2150 Country Club Rd, Winston Salem, NC 27104-4241 2008-01-29
1013127299 Amer I Aladin Internal Medicine Medical Center Boulevard Department of Cardiology, Winston Salem, NC 27157-1045 2007-05-23
1366493751 Barbara A Pisani Internal Medicine Medical Ctr, Winston Salem, NC 27157-0001 2006-05-12
1245288786 Forsyth Medical Group, LLC Internal Medicine 2000 Frontis Plaza Blvd Ste 102, Winston Salem, NC 27103-5616 2006-05-05
1497739189 Bt Heart and Vascular Center, Pllc Internal Medicine 150 Charlois Blvd, Suite 223, Winston Salem, NC 27103-1549 2005-12-06
1871587923 Kenneth E Bodek Internal Medicine 186 Kimel Park Dr, Suite 400, Winston Salem, NC 27103-6946 2005-09-06
1376195669 Chloe Erin Decklever Internal Medicine Medical Center Blvd, Winston Salem, NC 27157-0001 2019-07-16
1619529351 Matthew Tyler Watson Internal Medicine Medical Center Blvd, Winston Salem, NC 27157-0001 2019-07-12
1285298190 Hannah Marie Mccallum Internal Medicine Medical Center Boulevard, Winston Salem, NC 27157-0001 2019-04-25
1861913600 Jade Mccormick Kiger Internal Medicine Medical Center Blvd, Winston Salem, NC 27157-8708 2017-07-02
Find all providers in WINSTON SALEM

Competitor

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City WINSTON SALEM
Zip Code 27103

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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