NOVANT MEDICAL GROUP, INC (NPI# 1225418072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225418072 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH PEDIATRIC CARDIOLOGY WINSTON SALEM |
| Practice Address |
1900 S. Hawthorne Road Suite 614 Winston Salem NC 27103 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043847606 |
| Practice Fax Number | 3362777722 |
| Mailing Telephone | 7043847606 |
| Mailing Fax Number | 3362777722 |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatric Cardiology Winston Salem | 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 |
1900 S. HAWTHORNE ROAD SUITE 614 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103 |
| 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 | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619599198 | Novant Medical Group, Inc. | Pediatrics | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2020-05-07 |
| 1043657398 | Nathaniel Robbins | Pediatrics | Wake Forest University Baptist Medical Ctr, Medical Center Blvd, Winston Salem, NC 27157-0001 | 2013-05-28 |
| 1750487740 | Matthew Alan Hazle | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-09-16 |
| 1568577633 | Derek Adam Williams | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-08-20 |
| 1154305878 | Wesley Covitz | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912354374 | Carolina Children's Heart Specialists | Pediatrics | 1018 W H Smith Boulevard, Greenville, NC 27834 | 2016-05-16 |
| 1215317060 | Forsyth Memorial Hospital, Inc | Pediatrics | 1941 New Garden Road, Suite 216, Greensboro, NC 27410 | 2015-06-08 |
| 1487903423 | Private Diagnostic Clinic, Pllc | Pediatrics | 540 New Waverly Place, Ste.101, Cary, NC 27518-7422 | 2012-09-06 |
| 1548525470 | Bailliard Henry Pediatric Cardiology | Pediatrics | 4301 Lake Boone Trail, Suite 300, Raleigh, NC 27607 | 2012-07-06 |
| 1275858698 | Carolinas Physicians Network, Inc. | Pediatrics | 705 Griffith Street, Suite 100, Davidson, NC 28036-9305 | 2010-03-29 |
| 1073838496 | Carolinas Physicians Network, Inc. | Pediatrics | 6030 West Highway 74, Suite F, Indian Trail, NC 28079-3469 | 2010-03-29 |
| 1952626376 | Carolinas Physicians Network, Inc. | Pediatrics | 14214 Ballantyne Lake Road, Suite 150, Charlotte, NC 28277-3373 | 2010-03-29 |
| 1902121320 | Carolinas Physicians Network Inc | Pediatrics | 16623 Birkdale Cmns Pkwy Ste 110, Huntersville, NC 28078-5622 | 2010-03-29 |
| 1801023494 | Patsy W Park | Pediatrics | 1545 Orchard Villas Ave Ste 110, Apex, NC 27502-4339 | 2009-06-22 |
| 1114152469 | Frances Chen Travelli | Pediatrics | 1718 E 4th St Ste 605, Charlotte, NC 28204-3282 | 2009-05-15 |
| Find all providers with the same taxonomy | ||||
| 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.