NPIMap

Organization Active NPI

Foundation Health Systems Corp

Doing business as Novant Health Sports Performance & Rehab

  • Physical Medicine & Rehabilitation Physician
  • Clemmons, NC
National Provider Identifier
1730716267
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
FOUNDATION HEALTH SYSTEMS CORP
Doing business as
Novant Health Sports Performance & Rehab
Practice address
7210 Village Medical Cir Ste 115
Clemmons, NC 27012-8029
Phone
(336) 893-2460
NPI assigned
Mar 25, 2020
Organization subpart
Yes
Parent organization
FOUNDATION HEALTH SYSTEMS CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

7210 Village Medical Cir Ste 115
Clemmons, NC 27012-8029

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other names 1

  • Novant Health Sports Performance & Rehab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Foundation Hea LTH System30 organizations share this tax ID, including this one
Part of
Foundation Hea LTH System

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1730716267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 VILLAGE MEDICAL CIR STE 115",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128029",
            "telephone_number": "336-893-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION HEALTH SYSTEMS CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUNDATION HEALTH SYSTEMS CORP",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "704-316-7845"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Sports Performance & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.