Novant Health Medical Group Coastal Region, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC

Doing business as

Glen Meade Center for Women's Health

Practice address

1809 Glen Meade Rd
Wilmington, NC 28403-6022

Phone

(910) 763-9833

NPI assigned

Mar 31, 2021

Last updated

Jul 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shala Davis

Title

RCS Manager

Phone

(704) 303-7517

Specialties & licenses 1

Addresses

Other names 1

• Glen Meade Center for Women's Health Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sara Lynn Borcherding

  • Hospitalist Physician
  • Wilmington, NC
  • NPI 1831113885
  NPD
• Luke Samuel Clark, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1417425240
  NPD
• Victoria Marie Franklin, WHNP

  • Nurse Practitioner
  • Wilmington, NC
  • NPI 1902109085
  NPD
• Cynthia Dixon Grant, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1649771536
  NPD
• Brian James Monroe, PA-C

  • Physician Assistant
  • Oak Island, NC
  • NPI 1740671650
  NPD

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1801474705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036022",
            "telephone_number": "910-763-9833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Carolina Bay Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032046",
            "country_code": "US",
            "telephone_number": "910-763-9833",
            "fax_number": "910-763-5166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1333 S Dickinson Dr Unit 230",
            "address_purpose": "LOCATION",
            "city": "Leland",
            "state": "NC",
            "postal_code": "284516434",
            "country_code": "US",
            "telephone_number": "910-763-9833",
            "fax_number": "910-763-5166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Meade Center for Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.