NOVANT MEDICAL GROUP, INC (NPI# 1962048512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962048512 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Practice Address |
1400 Westgate Ctr Dr Ste 110 Winston Salem NC 27103-3104 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9803029307 |
| Practice Fax Number | 7043169859 |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-11-19 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | Y |
| Parent Organization Name | NOVANT MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Diabetes & Nutrition | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1831500354 | Novant Medical Group, Inc | Orthopaedic Surgery | Robinhood Medical Plaza Bldg 200, Winston Salem, NC 27106 | 2014-05-19 |
| 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 |
1400 WESTGATE CTR DR STE 110 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-3104 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043876055 | Iora Health North Carolina, P.C. | Internal Medicine | 3274 Silas Creek Pkwy, Winston Salem, NC 27103-3010 | 2019-05-15 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1740636125 | Joshua W Harbaugh | Internal Medicine | Gme Office Wfbmc Medical Center Blvd, Winston Salem, NC 27157-0001 | 2016-05-04 |
| 1922495795 | Lauren Marie Hartman | Internal Medicine | Sticht Center, 1 Medical Center Blvd, Winston Salem, NC 27517 | 2015-04-20 |
| 1952798985 | Adam Ross Schertz | Internal Medicine | Wake Forest Medical Ctr, Medical Center Blvd, Watlington Hall, 3rd Floor, Winston Salem, NC 27157-0001 | 2015-04-16 |
| 1881002319 | Glorian Mari Roman-ashby | Internal Medicine | Geriatric Clinic-sticht Center Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2014-07-28 |
| 1457648412 | Jiaxi Ding | Internal Medicine | 1340 Creekshire Way Ste 100, Winston Salem, NC 27103-3063 | 2011-06-28 |
| 1730319583 | Jennifer L Gabbard | Internal Medicine | 1 Medical Center Blvd 8th Floor Janeway Tower, Winston Salem, NC 27157-0001 | 2009-07-14 |
| 1730349309 | Willis S Mozingo | Internal Medicine | Wfubmc House Staff Ofc, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2008-06-16 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 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.