NOVANT MEDICAL GROUP INC (NPI# 1841848249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841848249 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH STROKE BRIDGE CLINIC |
| Practice Address |
190 Kimel Park Dr Ste 131 Winston Salem NC 27103-6946 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3367187063 |
| Practice Fax Number | 3367189861 |
| Mailing Telephone | 3367187063 |
| Mailing Fax Number | 3367189861 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2020-01-03 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Stroke Bridge Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1205355799 | Novant Medical Group Inc | Family Medicine | 16525 Holly Crest Ln Ste 250, Huntersville, NC 28078-4912 | 2017-09-15 |
| 1679090468 | Novant Medical Group Inc | Internal Medicine | 12311 Copper Way Ste 100, Charlotte, NC 28277-3643 | 2017-08-23 |
| 1003332016 | Novant Medical Group Inc | Internal Medicine | 10030 Gilead Rd Ste 344, Huntersville, NC 28078-7545 | 2017-08-22 |
| 1255709432 | Novant Medical Group Inc | Family Medicine | 19485 Old Jetton Road, Suite 100, Cornelius, NC 28031-6583 | 2015-09-04 |
| 1215326665 | Novant Medical Group Inc | Surgery | 819 N Atlantic Ave, Southport, NC 28461-3531 | 2015-01-22 |
| 1194113662 | Novant Medical Group Inc | Obstetrics & Gynecology | 1730 Kernersville Medical Parkway, Suite 104, Kernersville, NC 27284-7198 | 2015-01-06 |
| 1437556594 | Novant Medical Group Inc | Internal Medicine | 13 Medical Campus, Suite 102, Supply, NC 28462-4093 | 2014-12-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Novant Medical Group Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Novant Medical Group Inc. | 2085 Frontis Plaza Blvd, Winston Salem, North Carolina 27103 |
| Street Address |
190 KIMEL PARK DR STE 131 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-6946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194917732 | Todd Michael Reiter | Physical Medicine & Rehabilitation | 190 Kimel Park Dr Ste 131, Winston Salem, NC 27103-6946 | 2007-08-17 |
| 1265080089 | Novant Medical Group, Inc. | Physical Therapist | 190 Kimel Park Dr Ste 131, Winston Salem, NC 27103-6946 | 2019-08-27 |
| 1720277874 | Jill Thomas Atwood | Audiologist | 190 Kimel Park Dr Ste 131, Winston Salem, NC 27103-6946 | 2007-10-15 |
| 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 |
| 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 |
| 1780063958 | Novant Medical Group, Inc. | Psychiatry & Neurology | 2025 Frontis Plaza Blvd, Suite 120, Winston Salem, NC 27103-5663 | 2015-05-21 |
| 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 |
Please comment or provide details below to improve the information on NOVANT MEDICAL GROUP INC.
| 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.