NOVANT MEDICAL GROUP, INC (NPI# 1649635954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649635954 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH CANCER INSTITUTE |
| Practice Address |
1010 Bethesda Ct Winston Salem NC 27103-3019 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3362776000 |
| Practice Fax Number | 3362776001 |
| Mailing Telephone | 3362776000 |
| Mailing Fax Number | 3362776001 |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | SHALA DAVIS (RCS MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Cancer Genetics Clinic | Doing Business As Name - Organization |
| Novant Health Cancer Institute | 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 |
1010 BETHESDA CT |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-3019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245210707 | Piedmont Hematology-oncology Associates, Pllc | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2006-01-20 |
| 1497361455 | Dominika Bajguz | Genetic Counselor, MS | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2020-09-16 |
| 1003300609 | Daria Wuycik Wooten | Pharmacist | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2018-06-18 |
| 1083119366 | Sarah Caitlin Hughes | Genetic Counselor, MS | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2018-03-28 |
| 1104321470 | Erica Lynn Cousins | Genetic Counselor, MS | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2018-03-28 |
| 1215484340 | Novant Medical Group | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2016-09-07 |
| 1659737757 | Novant Medical Group, Inc | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2016-01-06 |
| 1912348483 | Novant Medical Group Inc | Hospitalist | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2013-07-12 |
| 1083934343 | Elizabeth Miles Haynes | Physician Assistant | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2010-06-09 |
| 1154560621 | Sarah Rebecca Johnson | Nurse Practitioner | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2009-02-06 |
| Find all providers in the same location | ||||
| 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 | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770567729 | Tamison Jewett | Medical Genetics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811191679 | Bradford Cole Powell | Medical Genetics | 5078 Genetic Medicine Bldg, Campus Box 7264, Chapel Hill, NC 27599-7264 | 2007-06-13 |
| 1508336157 | Mission Community Anesthesiology Specialists LLC | Medical Genetics | 11 Vanderbilt Park Drive, Asheville, NC 28803 | 2018-11-27 |
| 1972765220 | Berrin Monteleone | Medical Genetics | 1001 Blythe Blvd, Medical Center Plaza, Suite 200, Charlotte, NC 28203-5866 | 2008-06-27 |
| 1336365360 | Sara Elrefai | Medical Genetics | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2007-04-18 |
| 1831248848 | Yuang-tsong Chen | Medical Genetics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2007-01-09 |
| 1427119080 | Margie L Jaworski | Medical Genetics | 2150 Herbert Ct, Ecu Physicians Pediatric Genetics, Greenville, NC 27834-3736 | 2006-12-13 |
| 1881798445 | Susan Sparks | Medical Genetics | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2006-09-12 |
| 1144204868 | Vandana Shashi | Medical Genetics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2005-12-06 |
| 1194716936 | Karen Russell Schmidt | Medical Genetics | 600 Moye Blvd, Ecu Physicians Pediatric Genetics, Greenville, NC 27834-4300 | 2005-11-01 |
| 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.