NOVANT MEDICAL GROUP, INC (NPI# 1497119283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497119283 |
Entity Type | Organization |
Organization Name | NOVANT MEDICAL GROUP, INC |
Other Organization Name | NOVANT HEALTH PELVIC HEALTH CENTER |
Practice Address |
770 Highland Oaks Dr Suite 100 Winston Salem NC 27103 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 3367181970 |
Practice Fax Number | 3367747105 |
Mailing Telephone | 7043849672 |
Enumeration Date | 2016-04-08 |
Last Update Date | 2018-05-24 |
Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
Authorized Official Telephone | 7043849672 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
N | 208C00000X | Colon & Rectal Surgery | Allopathic & Osteopathic Physicians | ||
Y | 2088F0040X |
Urology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Novant Health Pelvic Health Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | NOVANT MEDICAL GROUP, INC. | 200 Hawthorne Ln, Charlotte, NC 28204-2515 |
Street Address |
770 HIGHLAND OAKS DR SUITE 100 |
City | WINSTON SALEM |
State | NC |
Zip Code | 27103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205067006 | Lori Anne Baydush | Physical Therapist | 770 Highland Oaks Dr, Winston Salem, NC 27103-7105 | 2009-07-29 |
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 Code | 2088F0040X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
Specialization | Female Pelvic Medicine and Reconstructive Surgery |
A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437671443 | Arman Adam Kahokehr | Urology | Division of Urology Dumc 3146 Duke Clinics Cir Rm 1113, Durham, NC 27710-0001 | 2017-07-11 |
1821388034 | Marcella Gevonne Willis-gray | Urology | 3032 Old Clinic Bldg, Cb#7570, Chapel Hill, NC 27599-7570 | 2011-04-10 |
1437641164 | Novant Medical Group, Inc. | Urology | 1904 Jake Alexander Blvd W Ste 303, Salisbury, NC 28147-1177 | 2018-05-30 |
1033526181 | Moses Cone Affiliated Physicians, Inc. | Urology | 283 White Oak St, Asheboro, NC 27203-5431 | 2014-07-21 |
1407104466 | Carolinas Healthcare Associates, Inc. | Urology | 221 Memorial Dr, Jacksonville, NC 28546-6333 | 2012-08-24 |
1396918983 | Transylvania Physician Services, Inc. | Urology | 87 Medical Park Dr Ste A, Brevard, NC 28712-3210 | 2008-04-04 |
1235112897 | Vance F Merhoff | Urology | 911 W Henderson St, Ste 110, Salisbury, NC 28144-2736 | 2005-11-28 |
City | WINSTON SALEM |
Zip Code | 27103 |
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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.