Novant Health Medical Group Coastal Region, LLC
Organization Active NPI Hospitalist Physician · Wilmington, NC
NPI 1447845599 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1447845599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
- Practice address
- 2131 S 17TH St
Wilmington, NC 28401-7407 - Phone
- (910) 667-9407
- NPI assigned
- Mar 1, 2021
- Organization subpart
- No
Authorized official
- Name
- Shala Davis
- Title
- RCS Manager
- Phone
- (704) 303-7517
Practitioners 80
-
James Adgent, MD
-
Hayley Afanador, MD
-
Lilian Andries, MD
-
William Moore Beam II, M.D.
-
Todd Bibb, DO
-
Tony Blue, MD
-
William Rataphon Chamnin, PA-C
-
Carrie Ann Fales, MD
-
Brittany Forshay, MD
-
Adam Frank, MD
-
Ahmad Tayyab Haq, M.D.
-
Allen Jones, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210408000285 | NC | Part B Supplier - Clinic/Group Practice | 2860809936 |
Receives reassigned benefits from 798 practitioners This NPI is an additional NPI on the enrollment Practice locations: Wilmington, NC; Wilmington, NE; Boivia, NC; Bolivia, NC; Burgaw, NC; Carolina Shores, NC; Jacksonville, NC; Leland, NC… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | Yes |
Addresses
Primary practice location
2131 S 17TH St
Wilmington, NC 28401-7407
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 667-9407
Other names
- NHMGCR HOSPITALIST
Other providers in Wilmington, NC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
- Novant Health Medical Group Coastal Region, LLC
All providers in Wilmington, NC · Hospitalist 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 Aug 18, 2021. 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.