NMG Affilate Practice I LLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

NMG AFFILATE PRACTICE I LLC

Doing business as

Novant Health Oncology Specialists

Practice address

516 S Van Buren Rd
Eden, NC 27288-5019

Phone

(336) 623-9713

Fax

(336) 623-1031

NPI assigned

Oct 7, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Geoffrey Keith Gardner

Title

VP Finance

Phone

(704) 384-7603

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Novant Health Oncology Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• NMG Affiliate Practice I LLC

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1114222700

  O20061027000426

  Same enrollment
• NMG Affiliate Practice I LLC

  • Cardiovascular Disease Physician
  • Mount Airy, NC
  • NPI 1184929796

  O20061027000426

  Same enrollment
• NMG Affiliate Practice I LLC

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1558666164

  O20061027000426

  Same enrollment
• NMG Affiliate Practice I, LLC

  • Hematology & Oncology Physician
  • North Wilkesboro, NC
  • NPI 1538478813

  O20061027000426

  Same enrollment
• Uva Community Health Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Charlottesville, VA
  • NPI 1598475741

  O20061027000426

  Same enrollment

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1689077539",
    "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",
            "telephone_number": "704-384-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S VAN BUREN RD",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885019",
            "telephone_number": "336-623-9713",
            "fax_number": "336-623-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILATE PRACTICE I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "704-384-7603",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689077539",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Oncology Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Sherwood Neijstrom, M.D.
• New Abundant Living 3
• New Hope Solutions & Wellness Center
• New Leaf Counseling, PLLC
• Cynthia Lou Newby, REGISTERED NURSE RN
• North Carolina CVS Pharmacy LLC
• Novant Medical Group, Inc
• Ikenna B Okafor, PHARMD
• Opies of Eden
• Heidi Anne Orme, MS, CRNA

• Hematology & Oncology Physician in Eden, NC
• Providers in Eden, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.