NOVANT MEDICAL GROUP, INC. (NPI# 1619599198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619599198 |
Entity Type | Organization |
Organization Name | NOVANT MEDICAL GROUP, INC. |
Other Organization Name | NOVANT HEALTH PEDIATRIC CARDIOLOGY |
Practice Address |
1350 Whitaker Ridge Dr Winston Salem NC 27106-4966 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 3367182560 |
Practice Fax Number | 3367182569 |
Enumeration Date | 2020-05-07 |
Last Update Date | 2020-05-26 |
Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
Authorized Official Telephone | 7043167845 |
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 | 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 |
1350 WHITAKER RIDGE DR |
City | WINSTON SALEM |
State | NC |
Zip Code | 27106-4966 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013991066 | David Scott Anderson | Pediatrics | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2005-12-02 |
1578086179 | Alyssa Basen Light | Physician Assistant | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106 | 2017-07-25 |
1710345533 | Julie Lorraine Saul | Registered Nurse | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2016-02-08 |
1134515596 | Novant Medical Group, Inc. | Psychiatry & Neurology | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2015-04-13 |
1689078032 | Danielle Nicole Harper | Counselor | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2014-10-14 |
1548516594 | Amanda Valentine | Registered Nurse | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2012-07-27 |
1255697744 | Cashe C Emory | Nurse Practitioner | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106 | 2012-04-09 |
1003182015 | Soren Morgan Johnson | Pediatrics | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2012-03-24 |
1972886273 | Bethany Sellers Goodman | Nurse Practitioner | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106 | 2011-09-22 |
1245545300 | Forsyth Medical Group, LLC | Pediatrics | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2010-08-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437799103 | Tyler Laura Lawrence | Behavioral Analyst | 1959 N Peace, 104, Winston-salem, NC 27106 | 2020-01-10 |
1316504624 | Amanda Baker | Behavior Technician | 1959 N Peace Haven Rd, Suite 104, Winston Salem, NC 27106 | 2019-05-22 |
1679030316 | Lavonda Williams | Behavior Technician | 1959 N Peace Haven Road, Winston Salem, NC 27106 | 2019-03-01 |
1518436708 | Angela Ruth Brown | Physical Therapy Assistant | 190 Moravian Way Drive, Winston-salem, NC 27106 | 2018-11-16 |
1407378896 | Applied Family Services of Winston-salem | Early Intervention Provider Agency | 4220 Witherow Rd, Winston Salem, NC 27106 | 2017-07-07 |
1750801676 | Julia Ann Horton | Speech-Language Pathologist | 2000 Salemtowne Drive, Winston Salem, NC 27106 | 2017-06-21 |
1124548037 | Tyler John Jones | Community Health Worker | 7014 Brandemere Ln. Apt F, Winston Salem, NC 27106 | 2017-06-21 |
1396274759 | Jennifer Cui | Social Worker | 3216 Cross Tree Rd, Winston-salem, NC 27106 | 2017-06-08 |
1063947802 | Rebecca Jeanette Mclemore | Social Worker | 4401 Providence Ln. #121, Top Priority Care Services, LLC., Winston-salem, NC 27106 | 2017-05-01 |
1720529357 | Rising Hope Clinical Assistance, LLC | Community/Behavioral Health | 510 Northgate Park Dr, Winston Salem, NC 27106 | 2017-03-15 |
Find all providers in zip 27106 |
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 |
---|---|---|---|---|
1225418072 | Novant Medical Group, Inc | Pediatrics | 1900 S. Hawthorne Road, Suite 614, Winston Salem, NC 27103 | 2015-06-08 |
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 | 27106 |
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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.