Novant Health Medical Group Coastal Region, LLC
Organization Active NPI Hematology & Oncology Physician · Wilmington, NC
NPI 1699355206 · NPPES record last updated Jul 19, 2021
Key facts
- NPI
- 1699355206
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
- Practice address
- 2131 S 17TH St
Wilmington, NC 28401-7407 - Phone
- (910) 667-3000
- NPI assigned
- Apr 9, 2021
- Organization subpart
- No
Authorized official
- Name
- Shala Davis
- Title
- RCS Manager
- Phone
- (704) 303-7517
Corporate family (same tax ID) 24
Practitioners 6
-
Eric Louis Scofield, MD, MPH
-
Michelle Lee Taylor, AGNP-C
-
Syrii Beyer, PA-C
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
- Tax ID family
- Novant Health Medical Group Coastal Region LLC
Locations
109 Scotts Hill Medical Dr
Ste 102
Wilmington, NC 28411
Phone (910) 662-1730
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
2131 S 17TH St
Wilmington, NC 28401-7407
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Other names
- Cape Fear Cancer Specialists
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 · Hematology & Oncology 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 19, 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.