NPIMap

Organization Active NPI

Novant Health Thomasville Medical Center, LLC

  • Internal Medicine Physician
  • Kernersville, NC
National Provider Identifier
1346027463
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NOVANT HEALTH THOMASVILLE MEDICAL CENTER, LLC
Practice address
1471 Jag Branch Blvd Unit 105
Kernersville, NC 27284-6963
Phone
(980) 301-9802
NPI assigned
Sep 12, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(336) 515-7085

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 12

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

Practitioners 3

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031222000916 NC Part B Supplier - Clinic/Group Practice 5890605224 Receives reassigned benefits from 747 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Winston-Salem, NC; Winston Salem, NC; Thomasville, NC; Kernersville, NC; Clemmons, NC

National Provider Directory

National Provider Directory
Tax ID family
Community Gen Hospital (13 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1471 Jag Branch Blvd Unit 105
Kernersville, NC 27284-6963

Mailing address

PO Box 935983
Atlanta, GA 31193-6857
Phone (980) 302-9801

Other names 1

NPPES NPI Registry
  • Novant Health Infusion Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 5, 2024.

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1346027463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935983",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "980-302-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 JAG BRANCH BLVD UNIT 105",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272846963",
            "telephone_number": "980-301-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH THOMASVILLE MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "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": "336-515-7085"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Infusion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Infusion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.