NOVANT MEDICAL GROUP, INC. (NPI# 1104310374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104310374 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH ADULT PRIMARY CARE HARPER HILL |
| Practice Address |
4937 Old Country Club Rd Winston Salem NC 27104 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3367184510 |
| Practice Fax Number | 3367184519 |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-08-07 |
| 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 |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Adult Primary Care Harper Hill | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033723531 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy Ste 320, Matthews, NC 28105-2389 | 2020-09-02 |
| 1346868155 | Novant Medical Group, Inc. | Family Medicine | 106 Corporate Park Dr Ste 200, Mooresville, NC 28117-7134 | 2020-07-08 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1932725124 | Novant Medical Group, Inc. | Internal Medicine | 125 Queens Rd Ste 510, Charlotte, NC 28204-3215 | 2020-06-23 |
| 1922645571 | Novant Medical Group, Inc. | Surgery | 6324 Fairview Rd Ste 420, Charlotte, NC 28210-3372 | 2019-12-03 |
| 1437706256 | Novant Medical Group, Inc. | Physical Therapist | 11202 Harris Rd, Huntersville, NC 28078-7633 | 2019-08-26 |
| 1336795137 | Novant Medical Group, Inc. | Surgery | 3515 W Market St Ste 310, Greensboro, NC 27403-4438 | 2019-08-16 |
| 1104472125 | Novant Medical Group, Inc. | Neurological Surgery | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-15 |
| 1649824954 | Novant Medical Group, Inc. | Family Medicine | 6555 Kee Lane, Harrisburg, NC 28075-7463 | 2019-07-25 |
| 1285287185 | Novant Medical Group, Inc. | Lactation Consultant, Non-RN | 6324 Fairview Rd Ste 435, Charlotte, NC 28210-4278 | 2019-07-19 |
| 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 |
4937 OLD COUNTRY CLUB RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945937 | Taqiyyah Zafirah Betties | Nurse Practitioner | 4937 Old Country Club Rd, Winston Salem, NC 27104-5071 | 2019-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| 1083040430 | Jennifer Nichole Darago | Pharmacist | 500 Park Ridge Ct Apt B, Winston-salem, NC 27104 | 2013-09-17 |
| Find all providers in zip 27104 | ||||
| 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 |
| 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 |
| 1477757052 | Juan Armando Pena | Internal Medicine | Wake Forest Baptist Health Dept Ofobgyn, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2007-06-14 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
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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.