NPIMap

Organization Active NPI

NMG Affiliate Practice I, LLC

  • Family Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1487218871
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NMG AFFILIATE PRACTICE I, LLC
Doing business as
Novant Health Care Connections Senior Care
Practice address
190 Moravian Way Dr
Winston Salem, NC 27106-3216
Phone
(336) 856-0701
Fax
(336) 856-2804
NPI assigned
May 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Authorized official

Name
Shala Davis
Title
RCS Manager
Phone
(704) 316-7845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

190 Moravian Way Dr
Winston Salem, NC 27106-3216

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Novant Health Care Connections Senior Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
NMG Affilate Practice I LLC42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1487218871",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 MORAVIAN WAY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063216",
            "telephone_number": "336-856-0701",
            "fax_number": "336-856-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-7845"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Care Connections Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.