Novant Health Brunswick Endoscopy Center, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

NOVANT HEALTH BRUNSWICK ENDOSCOPY CENTER, LLC

Doing business as

Novant Health Brunswick Endoscopy CRNAS

Practice address

13 Medical Campus Drive
Suite 101
Supply, NC 28462

Phone

(910) 721-4300

Fax

(910) 721-4309

NPI assigned

Jul 26, 2017

Last updated

Jul 26, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shelborn Stevens

Title

President & Coo

Phone

(910) 721-1456

Specialties & licenses 1

Addresses

Other names 1

• Novant Health Brunswick Endoscopy CRNAS Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Novant Health Brunswick Endoscopy Center, LLC

  dba Novant Health Brunswick Endoscopy

  • Ambulatory Surgical Clinic/Center
  • Supply, NC
  • NPI 1821510579

  O20180220000063

  Same enrollment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501027200000",
    "number": "1023532686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "336-277-7226",
            "fax_number": "336-277-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 MEDICAL CAMPUS DRIVE",
            "address_2": "SUITE 101",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "28462",
            "telephone_number": "910-721-4300",
            "fax_number": "910-721-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH BRUNSWICK ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "SHELBORN",
        "authorized_official_title_or_position": "PRESIDENT & COO",
        "authorized_official_telephone_number": "910-721-1456"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Brunswick Endoscopy CRNAS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Brunswick Endoscopy CRNAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Moving Ahead Counseling Services
• Crystal Dawn Murphy, C-PNP
• New Life Sleep Consultants Inc.
• Eunika Nichole Norman, LCSWA
• North Carolina Physician Network, Inc. (Brunswick Women's Center)
• Novant Health Brunswick Endoscopy Center, LLC (Novant Health Brunswick Endoscopy)
• Novant Health Medical Group LLC (Novant Health Gastroenterology Brunswick)
• Novant Health Medical Group NC Coastal Region Specialty, LLC (NH Coastal Ortho Clinics)
• Novant Health Medical Group NC Coastal Region Specialty, LLC (Novant Health Leighton Orthopedics & Sports Medicine)
• Novant Health Medical Group, LLC (Novant Health Orthopedics & Sports Medicine)

• Certified Registered Nurse Anesthetist in Supply, NC
• Providers in Supply, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.