NOVANT MEDICAL GROUP, INC. (NPI# 1780063958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780063958 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH NEUROLOGY AND SLEEP |
| Practice Address |
2025 Frontis Plaza Blvd Suite 120 Winston Salem NC 27103-5663 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3362772200 |
| Practice Fax Number | 3362772210 |
| Mailing Telephone | 3362772200 |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2017-08-29 |
| Authorized Official Name | GEOFFREY F GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043167585 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Neurology and Sleep | 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 |
2025 FRONTIS PLAZA BLVD SUITE 120 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-5663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487654216 | Dianna Lynn Seldomridge | Ophthalmology | 2025 Frontis Plaza Blvd, Suite 100, Winston Salem, NC 27103-5663 | 2005-07-22 |
| 1750875092 | Spencer Ray Martin | Physician Assistant | 2025 Frontis Plaza Blvd, Winston Salem, NC 27103-5663 | 2018-06-20 |
| 1679820419 | Ashley Monroe Campbell | Nurse Practitioner | 2025 Frontis Plaza Blvd, Suite 120, Winston Salem, NC 27103-5663 | 2012-08-11 |
| 1649534629 | Meredith M. Williams | Physician Assistant | 2025 Frontis Plaza Blvd, Suite 200, Winston Salem, NC 27103-5663 | 2012-06-25 |
| 1902050321 | Sean Patrick Giese | Nurse Practitioner | 2025 Frontis Plaza Blvd, Suite 120, Winston Salem, NC 27103-5663 | 2008-11-12 |
| 1932351830 | Dhyan Rajan | Internal Medicine | 2025 Frontis Plaza Blvd, Suite 200, Winston Salem, NC 27103-5663 | 2008-10-22 |
| 1427213149 | Apsara Prasad | Internal Medicine | 2025 Frontis Plaza Blvd, Suite 200, Winston Salem, NC 27103-5663 | 2008-07-22 |
| 1518120187 | Ashley H. Long | Physician Assistant | 2025 Frontis Plaza Blvd, Suite 200, Winston Salem, NC 27103-5663 | 2008-07-03 |
| 1053571620 | Marcum G Gillis | Internal Medicine | 2025 Frontis Plaza Blvd, Suite 200, Winston Salem, NC 27103-5663 | 2008-06-16 |
| 1306005343 | Digestive Health Specialists, Pa | Clinic/Center | 2025 Frontis Plaza Blvd, Suite 200, Winston Salem, NC 27103-5663 | 2008-06-05 |
| Find all providers in the same location | ||||
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811417835 | Arvind Muralimohan Gomadam | Psychiatry & Neurology | 1492 Rymco Dr, Winston Salem, NC 27103 | 2017-06-21 |
| 1760802474 | Michael Verenes | Psychiatry & Neurology | 2025 Frontis Plaza Blvd Ste 120, Winston Salem, NC 27103 | 2014-04-21 |
| 1245539212 | David Hosford | Psychiatry & Neurology | 200 E 1st St Ste 300, Winston Salem, NC 27101-4165 | 2011-03-16 |
| 1447334388 | Margaret Louise Craig | Psychiatry & Neurology | 1915 Cadman Forest Drive, Winston Salem, NC 27127-4684 | 2006-10-25 |
| 1841848249 | Novant Medical Group Inc | Psychiatry & Neurology | 190 Kimel Park Dr Ste 131, Winston Salem, NC 27103-6946 | 2019-08-28 |
| 1043713910 | Novant Medical Group, Inc. | Psychiatry & Neurology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2018-03-16 |
| 1134656143 | Novant Medical Group Inc | Psychiatry & Neurology | 190 Kimel Park Dr Ste 121, Winston Salem, NC 27103-6946 | 2017-05-22 |
| 1649655028 | Devanshi Dharaiya | Psychiatry & Neurology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103 | 2015-07-27 |
| 1568857480 | Tamra Ishan Jayendra Ranasinghe | Psychiatry & Neurology | Medical Center Blvd, Winston Salem, NC 27157-9180 | 2015-03-30 |
| 1629481577 | Paola Castri | Psychiatry & Neurology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2014-06-09 |
| Find all providers in WINSTON SALEM | ||||
| 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.