NOVANT MEDICAL GROUP (NPI# 1689917783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689917783 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP |
| Other Organization Name | NOVANT HEALTH NUTRITION SOLUTIONS |
| Practice Address |
5175 Old Clemmons School Rd Clemmons NC 27012-9087 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3367186770 |
| Practice Fax Number | 3362771889 |
| Mailing Telephone | 3367186770 |
| Mailing Fax Number | 3362771889 |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-11-29 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF NMG FINANCE) |
| Authorized Official Telephone | 7043849144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| Novant Health Nutrition Solutions | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669620910 | Novant Medical Group | Family Medicine | 143 Marginal Street, Cooleemee, NC 27014-0910 | 2008-08-28 |
| 1215484340 | Novant Medical Group | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2016-09-07 |
| 1063833424 | Novant Medical Group | Internal Medicine | 1718 E 4th St, Suite 401, Charlotte, NC 28204-3261 | 2014-01-02 |
| 1982945242 | Novant Medical Group | Obstetrics & Gynecology | 2711 Randolph Rd, Suite 512, Charlotte, NC 28207-2034 | 2013-03-12 |
| 1447504063 | Novant Medical Group | Dietitian, Registered | 1710 Kernersville Medical Pkwy, Suite 210, Kernersville, NC 27284-7157 | 2012-11-05 |
| 1255689212 | Novant Medical Group | Orthopaedic Surgery | 1401 Matthews Township Pkwy Ste 210, Matthews, NC 28105-5403 | 2012-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Novant Medical Group Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Novant Medical Group Inc. | 2085 Frontis Plaza Blvd, Winston Salem, North Carolina 27103 |
| System for Award Management (SAM) Entities | NOVANT MEDICAL GROUP, INC. | 200 Hawthorne Ln, Charlotte, NC 28204-2515 |
| Street Address |
5175 OLD CLEMMONS SCHOOL RD |
| City | CLEMMONS |
| State | NC |
| Zip Code | 27012-9087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659510832 | Michael Elliott Harris | Physician Assistant | 5175 Old Clemmons School Rd, Clemmons, NC 27012-9087 | 2009-02-12 |
| 1750933719 | Kelsey George | Behavior Technician | 5175 Old Clemmons School Rd, Clemmons, NC 27012-9087 | 2019-07-10 |
| 1265894612 | Elisabeth Dowlen | Pediatrics | 5175 Old Clemmons School Rd, Clemmons, NC 27012 | 2016-03-24 |
| 1366873325 | Forysth Medical Group, Inc | Internal Medicine | 5175 Old Clemmons School Rd, Clemmons, NC 27012-9087 | 2013-12-02 |
| 1740554153 | Nedrea Arnice Bell | Assistant Behavior Analyst | 5175 Old Clemmons School Rd, Clemmons, NC 27012-9087 | 2012-03-02 |
| 1871800268 | Forsyth Medical Group, LLC | Pediatrics | 5175 Old Clemmons School Rd, Clemmons, NC 27012-9087 | 2010-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427697978 | Novant Health Clemmons Outpatient Surgery, LLC | Nurse Anesthetist, Certified Registered | 7210 Village Medical Circel, Ste 235, Clemmons, NC 27012 | 2020-01-02 |
| 1528521887 | Novant Health Clemmons Outpatient Surgery, LLC | Clinic/Center | 7210 Village Medical Circle, Suite # 235, Clemmons, NC 27012 | 2019-04-12 |
| 1710382411 | Forsyth Memorial Hospital, Inc | Internal Medicine | 7114 Villiage Medical Circle, Clemmons, NC 27012 | 2014-10-24 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 1912323635 | Lutheran Home - Forsyth County, Inc. | Skilled Nursing Facility | 7449 Fair Oaks Drive, Clemmons, NC 27012 | 2014-03-06 |
| 1487910758 | Kelly Elizabeth Kirkpatrick | Specialist/Technologist | 1735 Lewisville Clemmons Road, West Forsyth High School, Clemmons, NC 27012 | 2012-04-11 |
| 1366613663 | Psimed Pa | Psychiatry & Neurology | 2511-d Neudorf Rd, Clemmons, NC 27012 | 2008-03-14 |
| 1871797688 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 5175 Old Clemmons School Road, Clemmons, NC 27012 | 2007-06-14 |
| 1700970878 | Thomas M Anderson Dds Pa | Clinic/Center | 2245 Lewisville Clemmons Road Suite B, Clemmons, NC 27012 | 2006-10-03 |
| 1902998941 | Steven A Cuccia Dds Pa | Dentist | 2265 Lewisville Clemmons Rd, Suite A, Clemmons, NC 27012 | 2006-09-28 |
| Find all providers in zip 27012 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407306889 | Holly Peschken | Dietitian, Registered | 4130 Clemmons Rd, Clemmons, NC 27012-7520 | 2016-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184947 | Freely Fed | Dietitian, Registered | 1532 Wickerby Ct, Matthews, NC 28105-0322 | 2020-11-04 |
| 1023618774 | Shannon Vasilinda | Dietitian, Registered | 450 Lake Royale, Louisburg, NC 27549-9565 | 2020-10-30 |
| 1154921997 | Lauren Annelise Prigge | Dietitian, Registered | 3636 Castlegate Dr, Raleigh, NC 27616-9551 | 2020-10-30 |
| 1659971406 | Lauren Rubio-serrano | Dietitian, Registered | 21 Mount Vernon Cir, Asheville, NC 28804-2439 | 2020-10-30 |
| 1336749407 | Doretta Wright | Dietitian, Registered | 110 Highgrove Ct, Aberdeen, NC 28315-2149 | 2020-10-28 |
| 1003414756 | Christy Nell Quirk | Dietitian, Registered | 117 Oldham Pl, Chapel Hill, NC 27516-9004 | 2020-10-14 |
| 1801493291 | Fuel Nc Nutrition | Dietitian, Registered | 1107 Capital Blvd, Raleigh, NC 27603-1113 | 2020-10-08 |
| 1033716436 | Katherine Openshaw | Dietitian, Registered | 521 Walnut Creek Dr, Goldsboro, NC 27534-8997 | 2020-10-08 |
| 1184221665 | Jennifer M Ritchie | Dietitian, Registered | 4306 Kimmeridge Rd, Greensboro, NC 27406-9303 | 2020-10-07 |
| 1659978245 | Jaclyn Lee Atwater | Dietitian, Registered | 415 Yucca Ln, Wilmington, NC 28412-1042 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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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.