NPIMap

Organization Active NPI

Novant Health Northern Specialty Medical Group, LLC

Doing business as Novant Health Extended Care

  • Rural Health Clinic/Center
  • Mount Airy, NC
National Provider Identifier
1518865179
Registry record updated Oct 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NOVANT HEALTH NORTHERN SPECIALTY MEDICAL GROUP, LLC
Doing business as
Novant Health Extended Care
Practice address
119 Welch Rd Ste a
Mount Airy, NC 27030-5274
Phone
(336) 719-7200
NPI assigned
Oct 26, 2026
Last updated
Oct 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2026

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

Authorized official

Name
Alisha Hutchens
Title
President Acute Care Operations Tri
Phone
(336) 719-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

119 Welch Rd Ste a
Mount Airy, NC 27030-5274

Mailing address

PO Box 604537
Charlotte, NC 28260-4537

Other names 1

  • Novant Health Extended Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Northern Specialty Medical Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

119 Welch Rd
Ste A
Mount Airy, NC 27030
Phone (336) 719-6200

NPI Registry JSON

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

{
    "created_epoch": "1792972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793145600000",
    "number": "1518865179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604537",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WELCH RD STE A",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305274",
            "telephone_number": "336-719-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH NORTHERN SPECIALTY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-26",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A",
        "authorized_official_last_name": "HUTCHENS",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "PRESIDENT ACUTE CARE OPERATIONS TRI",
        "authorized_official_telephone_number": "336-719-7200"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Extended Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2026; 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.