Novant Health Medical Group, LLC
Organization Active NPI Critical Care Medicine (Internal Medicine) Physician · Winston Salem, NC
NPI 1336817345 · NPPES record last updated Jun 24, 2024
Key facts
- NPI
- 1336817345
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician 207RC0200X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Practice address
- 3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013 - Phone
- (336) 718-8383
- Fax
- (336) 718-9622
- NPI assigned
- Sep 3, 2021
- Organization subpart
- No
Authorized official
- Name
- Leea Jeanine Walton
- Title
- RCS Manager
- Phone
- (704) 316-6081
Practitioners 13
-
Blair Jordon Brown, M.D.
-
Tia M. Exline, NP
-
Melanie Reyer Markey, PA-C
-
Todd Jon Oswald, MD
-
Mitchell Martucci Somma, PA-C
-
Hassan Yousaf, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000692 | NC | Part B Supplier - Clinic/Group Practice | 1153234893 |
Receives reassigned benefits from 3,607 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician |
207RC0200X | Yes |
Addresses
Primary practice location
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-8383
Other names
- Novant Health Inpatient Critical Care
Other providers in Winston Salem, NC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
All providers in Winston Salem, NC · Critical Care Medicine (Internal Medicine) Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.