Novant Health Medical Group, LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

NOVANT HEALTH MEDICAL GROUP, LLC

Doing business as

Novant Health Brain & Spine Surgery
Novant Health Brain and Spine Surgery

Practice address

1730 Kernersville Medical Pkwy Ste 204
Kernersville, NC 27284-7198

Phone

(336) 515-7336

Fax

(336) 515-7339

NPI assigned

Apr 4, 2016

Last updated

Jun 20, 2024By 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

Leea Jeanine Walton

Title

RCS Manager

Phone

(704) 316-6081

Specialties & licenses 1

Addresses

Other names 2

• Novant Health Brain & Spine Surgery Doing business as
• Novant Health Brain and Spine Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

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.

• Jonathan Eliot Este Fisher, MD

  • Cardiovascular Disease Physician
  • Huntersville, NC
  • NPI 1508872995
  NPD
• Kristina Kerr Hipp, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1669020236
  NPD
• Tiffany Mendenhall Martin, PA-C

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1154576288
  NPD
• Menli Marie McCreight, PA-C

  • Physician Assistant
  • Greensboro, NC
  • NPI 1891517413
  NPD
• Janelle Marie Negron Rivera

  • Nurse Practitioner
  • Kernersville, NC
  • NPI 1699530089
  NPD (past)

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1275996571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-765-6637",
            "fax_number": "336-765-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 204",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847198",
            "telephone_number": "336-515-7336",
            "fax_number": "336-515-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Pineview Dr",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272843817",
            "country_code": "US",
            "telephone_number": "336-765-6637",
            "fax_number": "336-765-6964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Brain & Spine Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Brain and Spine Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group, LLC (Novant Health Inpatient Care Specialists Kernersvile)
• Novant Health Medical Group, LLC (Novant Health Forsyth Pediatrics After Hours)
• Novant Health Medical Group, LLC (Novant Health Breast Surgery)
• Novant Health Medical Group, LLC (Novant Health Forsyth Pediatrics)
• Novant Health Medical Group, LLC (Novant Health Neurology)
• Novant Health Medical Group, LLC (Novant Health Pineview Family Medicine)
• Novant Health Medical Group, LLC (Novant Health Surgical Wellness)
• Novant Health Medical Group, LLC (Novant Health Mothershed Foot & Ankle Specialists)
• Novant Health Medical Group, LLC (Novant Health Salem Surgical Associates)
• Novant Health Medical Group, LLC (Novant Health Deep River OBGYN)

• Neurological Surgery Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Neurological Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.