NPIMap

Organization Active NPI

Novant Health Matthews Medical Center LLC

Doing business as Novant Health Matthews Medical Center

  • General Acute Care Hospital
  • Matthews, NC
National Provider Identifier
1063463156
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H0270 Issued in NC
Legal business name
NOVANT HEALTH MATTHEWS MEDICAL CENTER LLC
Doing business as
Novant Health Matthews Medical Center
Practice address
1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone
(704) 384-6500
NPI assigned
May 13, 2006
Last updated
Mar 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Zachary Scott Landry
Title
President
Phone
(704) 384-6367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H0270 NC Primary

Addresses

Primary practice location

1500 Matthews Township Pkwy
Matthews, NC 28105-4656

Mailing address

101 N Cherry St Ste 600
Winston Salem, NC 27101-4013
Phone (336) 277-1604

Other identifiers 1

IdentifierTypeStateIssuer
1063463156MedicaidNC

Other names 1

  • Novant Health Matthews Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061218000450 NC Part A Provider - Hospital 6406845247 Practice locations: Charlotte, NC; Matthews, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063463156. Details of each certification follow.

Hospital certification: CCN 340171

Legal name
NOVANT HEALTH MATTHEWS MEDICAL CENTER LLC
Doing business as
NOVANT HEALTH MATTHEWS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 7, 1994
Last certification
May 15, 1998
Beds
102
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
May 18, 1983 in NC
Enrollment address
1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Novant Health Matthews Medical CenterCCN 340171 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Hospital M4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Vinay Patel Individual Corporate DirectorBot Member Jan 1, 2025
James C Johnson Individual Corporate DirectorBot Jan 1, 2017
Kandi Deitemeyer Individual Corporate OfficerTrustee Jan 1, 2021
Justin Rutledge Individual Corporate DirectorBot Member Jan 1, 2025
Carl S Armato Individual Corporate DirectorBot Member Nov 9, 2006
W-2 Managing Employee Jan 1, 2012
Kimberly a Case Individual Corporate DirectorBot Member May 1, 2021
Thaddeus Vontrell Jones Individual Corporate DirectorBoard Member Jan 1, 2018
John Morgan Lewis Individual Corporate DirectorTreasurer Jan 1, 2018
Zachary Scott Landry Individual Corporate OfficerPres & Coo Feb 19, 2024
W-2 Managing EmployeePres & Coo Feb 19, 2024
James Patrick Taylor Individual Corporate DirectorBoard Member Jan 1, 2019
Patrick a Wilson Individual Corporate OfficerBot Member May 1, 2023
Marsha Janelle Lyons Individual Corporate DirectorBot Jan 1, 2018
Louis G Lobo Individual Corporate OfficerTrustee Jan 1, 2021
Novant Health, Inc. Organization, Winston Salem, NC Non-profit 5% Or Greater Direct Ownership Interest May 18, 1983 100%
Saad Ehtisham Individual Corporate DirectorPresident Jan 1, 2021
Tera Black Individual Corporate DirectorBot Member Jan 1, 2025
Molly Grantham Individual Corporate DirectorBot Member Jan 1, 2025
Novant Health Southern Piedmont Region, LLC Organization, Winston-Salem, NC Non-profit 5% Or Greater Direct Ownership Interest May 18, 1983 100%
David Longo Individual Corporate DirectorBot Member Jan 1, 2025

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 27

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 27

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 941

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 941

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1063463156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N CHERRY ST STE 600",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014013",
            "telephone_number": "336-277-1604",
            "fax_number": "336-277-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MATTHEWS TOWNSHIP PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054656",
            "telephone_number": "704-384-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MATTHEWS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-384-6367"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "H0270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063463156",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Matthews Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Matthews Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.