NOVANT MEDICAL GROUP, INC.


Address: 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966
Phone: 3367182560

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0202X Pediatrics
Specialization: Pediatric Cardiology
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Novant Health Pediatric Cardiology Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities NOVANT MEDICAL GROUP, INC. 200 Hawthorne Ln, Charlotte, NC 28204-2515

Office Location

Street Address 1350 WHITAKER RIDGE DR
City WINSTON SALEM
State NC
Zip Code 27106-4966

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2080P0202X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Cardiology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City WINSTON SALEM
Zip Code 27106

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Dataset Information

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.

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