Novant Health Medical Group, LLC
Organization Active NPI Family Medicine Physician · Oak Ridge, NC
NPI 1497224703 · NPPES record last updated Jul 9, 2024
Key facts
- NPI
- 1497224703
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Practice address
- 7607 NC Highway 68 N Ste B
Oak Ridge, NC 27310-8803 - Phone
- (336) 643-3378
- Fax
- (336) 643-3670
- NPI assigned
- Nov 15, 2018
- Organization subpart
- No
Authorized official
- Name
- Leea Jeanine Walton
- Title
- RCS Manager
- Phone
- (704) 316-6081
Corporate family (same tax ID) 24
Practitioners 3
-
Courtney Still Keatts, AGNP
-
Marsha Lewis White, NP-C
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
- Tax ID family
- Presbyterian Inpt Care
Locations
115 Brown St
Ste 101
Granite Quarry, NC 28146
Phone (704) 279-1697
1471 Jag Branch Blvd
Unit 103
Kernersville, NC 27284
Phone (336) 515-7410
4705 S NC Highway 150
Ste C
Lexington, NC 27295
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
7607 NC Highway 68 N Ste B
Oak Ridge, NC 27310-8803
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other names
- Novant Health Northwest Family Medicine
Other providers in Oak Ridge, NC
- NC Health and Wellness Center Inc
- NC Intergrated Care Services
- North Carolina CVS Pharmacy LLC
- Northstate Medical Associates P.a.
- Novant Health Medical Group, LLC
- Oak Ridge Counseling PLLC
- Oak Ridge Physical Therapy, Inc.
- Matthew John Olmsted
- P 356 Enterprises, Inc
- Malori Parsells
All providers in Oak Ridge, NC · Family 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 Jul 9, 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.