NOVANT MEDICAL GROUP INC. (NPI# 1750788659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750788659 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC. |
| Other Organization Name | NOVANT HEALTH BLUE RIDGE MEDICAL ASSOCIATES |
| Practice Address |
301 Executive Park Blvd Winston Salem NC 27103-1505 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3367749000 |
| Practice Fax Number | 3367749012 |
| Mailing Telephone | 3367749000 |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847203 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Blue Ridge Medical Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1568973360 | Novant Medical Group Inc. | Internal Medicine | 1622 Highwoods Blvd Unit G105, Greensboro, NC 27410 | 2017-10-19 |
| 1093292997 | Novant Medical Group Inc. | Internal Medicine | 6316 Old Oak Ridge Rd Ste E, Greensboro, NC 27410-9940 | 2018-07-24 |
| 1710432976 | Novant Medical Group Inc. | Orthopaedic Surgery | 2337 Winterhaven Ln, Winston Salem, NC 27103-6792 | 2016-08-17 |
| 1346632676 | Novant Medical Group Inc. | Family Medicine | 490 Pineview Dr Ste A, Kernersville, NC 27284-3995 | 2015-02-24 |
| 1619398070 | Novant Medical Group Inc. | Internal Medicine | 1718 E 4th St, Suite 401, Charlotte, NC 28204-3261 | 2014-01-02 |
| 1457782849 | Novant Medical Group Inc. | Podiatrist | 445 Pineview Dr, Suite 230, Kernersville, NC 27284-3817 | 2013-12-10 |
| 1437588506 | Novant Medical Group Inc. | Podiatrist | 3641 Westgate Center Cir, Suite A, Winston Salem, NC 27103-2936 | 2013-11-08 |
| 1134558752 | Novant Medical Group Inc. | Obstetrics & Gynecology | 245 Charlois Blvd, Winston Salem, NC 27103-1507 | 2013-11-04 |
| 1346548898 | Novant Medical Group Inc. | Family Medicine | 8430 University Exec Park Dr Ste 685, Charlotte, NC 28262-1337 | 2011-03-08 |
| 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 |
| Street Address |
301 EXECUTIVE PARK BLVD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1505 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518353689 | Nicholas Roth Schoenbachler | Obstetrics & Gynecology | 111 Hanestown Ct # 151, Winston Salem, NC 27103 | 2015-04-15 |
| 1932528833 | Zineb Mashak | Obstetrics & Gynecology | 1 Medical Center Blvd Obgyn Department, Winston Salem, NC 27157 | 2014-04-08 |
| 1306274394 | Robert Paul Zammit | Obstetrics & Gynecology | 3624 Wickersham Ln, Winston Salem, NC 27106-3583 | 2013-10-29 |
| 1427315779 | Tristan Gonzalez-sanz | Obstetrics & Gynecology | 115 Hanestown Ct, Suite 151, Winston Salem, NC 27103 | 2012-04-11 |
| 1083986111 | Novant Medical Group, Inc | Obstetrics & Gynecology | 2909 Maplewood Avenue, Winston Salem, NC 27103 | 2012-02-06 |
| 1427230291 | Ray M Braquet | Obstetrics & Gynecology | 1806 South Hawthorne Road, Winston Salem, NC 27103 | 2007-12-03 |
| 1639288343 | Jonathan D Weston | Obstetrics & Gynecology | 495 N Cleveland Ave, Winston Salem, NC 27101-4334 | 2006-08-29 |
| 1053352435 | Douglas Wayne Miyazaki | Obstetrics & Gynecology | 770 Highland Oaks Dr Ste 100, Winston Salem, NC 27103-7105 | 2006-06-09 |
| 1821047846 | Michael J Pollak | Obstetrics & Gynecology | 941 Bryans Place Rd, Winston Salem, NC 27104-5007 | 2006-05-08 |
| 1043283211 | Laura Best Ramsay | Obstetrics & Gynecology | 114 Charlois Blvd, Winston Salem, NC 27103-1522 | 2006-02-08 |
| Find all providers in WINSTON SALEM | ||||
| 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.