NMG AFFILATE PRACTICE I LLC (NPI# 1689077539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689077539 |
| Entity Type | Organization |
| Organization Name | NMG AFFILATE PRACTICE I LLC |
| Other Organization Name | NOVANT HEALTH ONCOLOGY SPECIALISTS |
| Practice Address |
516 S Van Buren Rd Eden NC 27288-5019 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3366239713 |
| Practice Fax Number | 3366231031 |
| Mailing Telephone | 7043847840 |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2015-05-14 |
| Authorized Official Name | MR. GEOFFREY KEITH GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043847603 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1689077539 | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Oncology Specialists | Doing Business As Name - Organization |
| Street Address |
516 S VAN BUREN RD |
| City | EDEN |
| State | NC |
| Zip Code | 27288-5019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306831961 | Boris M Darovsky | Internal Medicine | 516 S Van Buren Rd, Eden, NC 27288-5019 | 2005-09-20 |
| 1821463027 | Novant Medical Group, Inc | Internal Medicine | 516 S Van Buren Rd, Eden, NC 27288-5019 | 2015-12-14 |
| 1366495822 | Eric Sherwood Neijstrom | Internal Medicine | 516 S Van Buren Rd, Eden, NC 27288-5019 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781297 | Bailey Shea Scism | Pharmacist | 103 W Stadium Dr., Eden, NC 27288 | 2020-08-17 |
| 1538640628 | Donnell Corey Brown Jr. | Technician | 519 Orchard Drive, Eden, NC 27288 | 2018-08-27 |
| 1851728182 | Linda Mitchell | Physical Therapy Assistant | 114 E Kings Hwy, Eden, NC 27288 | 2013-10-01 |
| 1033341573 | Central State of The Carolinas, Inc. | Day Training, Developmentally Disabled Services | 229 Cedar St., Eden, NC 27288 | 2009-08-18 |
| 1114186483 | Enrich Cosmetic Center | Internal Medicine | 406 B Thompson St, Eden, NC 27288 | 2008-06-03 |
| 1265630891 | John R. Dabbs Jr. Dc PC | Preferred Provider Organization | 405 Boone Road, Eden, NC 27288 | 2007-07-05 |
| 1235283961 | James Harrison Eggleston | Dentist | 113 West Arbor Lane, Eden, NC 27288 | 2007-01-22 |
| 1962563940 | Barbara Collins Tanner | Nurse Practitioner | 134 North Pierce Street, Morehead High School Student Health Center, Eden, NC 27288 | 2006-12-13 |
| 1285690974 | Robert Maurice Vaughn | Chiropractor | 405 Boone Rd, Eden, NC 27288 | 2006-04-22 |
| 1619930666 | Direct Respiratory Services | Durable Medical Equipment & Medical Supplies | 302a North Pierce Street, Eden, NC 27288 | 2006-04-10 |
| Find all providers in zip 27288 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356675011 | Morehead Memorial Hospital | Internal Medicine | 516 South Van Buren Road, Eden, NC 27288-5019 | 2009-09-29 |
| 1821463027 | Novant Medical Group, Inc | Internal Medicine | 516 S Van Buren Rd, Eden, NC 27288-5019 | 2015-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851909816 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 660, Charlotte, NC 28204-3215 | 2020-07-16 |
| 1346858487 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 560, Charlotte, NC 28204-3215 | 2020-07-15 |
| 1295343341 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 640, Charlotte, NC 28204-3215 | 2020-07-15 |
| 1881212215 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 520, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1720606486 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 400, Charlotte, NC 28204-3215 | 2020-07-09 |
| 1720606445 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 430, Charlotte, NC 28204-3215 | 2020-07-09 |
| 1235757352 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 420, Charlotte, NC 28204-3215 | 2020-07-07 |
| 1811517311 | Rowan Regional Medical Center, Inc. | Internal Medicine | 631 Mocksville Ave, Ste 1020, Salisbury, NC 28144-2731 | 2020-04-24 |
| 1154955995 | Mohamed Sobhy Elhusseini Yassin | Internal Medicine | 2400 Pratt St Ste 5000, Durham, NC 27705-3976 | 2020-03-02 |
| 1164944377 | David Michael Ashley | Internal Medicine | Department of Neurosurgery Duke University Ctr, Durham, NC 27710-0001 | 2017-07-10 |
| Find all providers with the same taxonomy | ||||
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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.