NPIMap

Organization Active NPI

Novant Health Enterprises Imaging, LLC

Doing business as Novant Health Imaging Sun City

  • Diagnostic Radiology Physician
  • Indian Land, SC
National Provider Identifier
1184419707
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NOVANT HEALTH ENTERPRISES IMAGING, LLC
Doing business as
Novant Health Imaging Sun City
Practice address
6237 Carolina Commons Dr Ste 110
Indian Land, SC 29707-4513
Phone
(704) 323-3699
Fax
(803) 849-8391
NPI assigned
Apr 14, 2025
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Mr. Wade Collins
Title
VP of Novant Health Ventures
Phone
(423) 677-0679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

6237 Carolina Commons Dr Ste 110
Indian Land, SC 29707-4513

Mailing address

6237 Carolina Commons Dr Ste 110
Indian Land, SC 29707-4513
Phone (704) 323-3699

Other names 1

  • Novant Health Imaging Sun City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260625000480 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3072095546 Practice locations: Indian Land, SC

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Enterprises Imaging LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

6237 Carolina Commons Dr
Ste 110
Indian Land, SC 29707
Phone (803) 266-7547

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1184419707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6237 CAROLINA COMMONS DR STE 110",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297074513",
            "telephone_number": "704-323-3699",
            "fax_number": "803-849-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6237 CAROLINA COMMONS DR STE 110",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297074513",
            "telephone_number": "704-323-3699",
            "fax_number": "803-849-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH ENTERPRISES IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "VP OF NOVANT HEALTH VENTURES",
        "authorized_official_telephone_number": "423-677-0679",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Imaging Sun City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indian Land, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.