Vidant Medical Group, LLC
Organization Active NPI Cardiac Rehabilitation Clinic/Center · Roanoke Rapids, NC
NPI 1750125035 · NPPES record last updated Dec 9, 2025
Key facts
- NPI
- 1750125035
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiac Rehabilitation Clinic/Center 261QR0404X
- Legal business name
- VIDANT MEDICAL GROUP, LLC
- Practice address
- 210 Smith Church Rd Ste B
Roanoke Rapids, NC 27870-4942 - Phone
- (252) 847-2376
- Fax
- (252) 847-7337
- NPI assigned
- Jun 21, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- VIDANT MEDICAL GROUP LLC
Authorized official
- Name
- Anthony Wayne Bartholomew
- Title
- VP, Operations
- Phone
- (252) 847-9067
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 2
Member organizations 1
Practitioners 986
-
Atif Saleem Abbasi, M.D
-
Linda Marie Abbott, FNP
-
Haritha Ackula, MBBS
-
Archana Rao Adikey, M.B.B.S
-
Tochukwu Nwamaka Agbata, M.D.
-
Adil Ahmed, MD
-
Warqaa M Akram, M.D.
-
Hassan Mahdi Al-Khalisy, M.D.
-
Afe Danielle Nkese Alexis, M.B.B.S., MSC
-
Eslam Galal Khalifa Ali, M.D.
-
David Huston Allgood, PA-C
-
Caroline Dorothea Ames, M.D.
-
Deepti Ananthula, MD
-
Albert Delton Anderson Jr., AGACNP
-
Susan Andracchi, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240828001342 | NC | Part B Supplier - Intensive Cardiac Rehabilitation | 0345343893 |
Receives reassigned benefits from 2 practitioners Practice locations: Roanoke Rapids, NC |
National Provider Directory
- Tax ID family
- Vidant Medical Group LLC
- Part of
- Vidant Medical Group LLC
Locations
210 Smith Church Rd
Ste B
Roanoke Rapids, NC 27870
Phone (252) 535-8870
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiac Rehabilitation Registered Nurse |
163WC3500X | |||
| Cardiac Rehabilitation Clinic/Center | 261QR0404X | Yes |
Addresses
Primary practice location
210 Smith Church Rd Ste B
Roanoke Rapids, NC 27870-4942
Mailing address
210 Smith Church Rd Ste B
Roanoke Rapids, NC 27870-4942
Phone (252) 847-2376
Other names
- ECU Health Physicians
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All providers in Roanoke Rapids, NC · Cardiac Rehabilitation Clinic/Center 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 Dec 9, 2025. 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.