Novant Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Rolesville Primary Care

Practice address

102 Southtown Cir
Rolesville, NC 27571-9591

Phone

(919) 554-9412

Fax

(919) 562-7013

NPI assigned

Jul 14, 2008

Organization subpart

Yes

Parent organization

NOVANT MEDICAL GROUP, INC.As reported in NPPES

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

Authorized official

Name

Dinesh Pai

Title

VP of Operations

Phone

(704) 384-9104

Specialties & licenses 1

Addresses

Other names 1

• Rolesville Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Presbyterian Inpt Care

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Patrick Stuart Jr., M.D.

  • Surgery Physician
  • Winston Salem, NC
  • NPI 1447212667
  NPD
• Kelley Annette Wallace, DO

  • Hospitalist Physician
  • Kernersville, NC
  • NPI 1174753727
  NPD

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1235393802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 902",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043261",
            "telephone_number": "919-554-9412",
            "fax_number": "919-562-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SOUTHTOWN CIR",
            "city": "ROLESVILLE",
            "state": "NC",
            "postal_code": "275719591",
            "telephone_number": "919-554-9412",
            "fax_number": "919-562-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVANT MEDICAL GROUP, INC.",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "PAI",
        "authorized_official_first_name": "DINESH",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "704-384-9104"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rolesville Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Myriad Homecare Agency, LLC
• Nathani DDS & Associates Rolesville (Ideal Dental Rolesville)
• Austin Jeannine Newsome, M.D.
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #03918)
• North Wake Eye Care, Dr. Stephen J. Merckle O.D., P.a. (North Wake Eye Care)
• One Way Transportation Service LLC
• Osborne Chiropractic Clinic LL PA
• Matthew B. Osborne, D.C.
• Britney Palazzo, CCC-SLP
• Kristian Partney, DPT

• Family Medicine Physician in Rolesville, NC
• Providers in Rolesville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.