NPIMap

Organization Active NPI

Novant Health Davis Medical Center, LLC

Doing business as Davis Regional Medical Center - Psych Hospital

  • Psychiatric Hospital
  • Statesville, NC
National Provider Identifier
1851148308
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
NOVANT HEALTH DAVIS MEDICAL CENTER, LLC
Doing business as
Davis Regional Medical Center - Psych Hospital
Practice address
218 Old Mocksville Rd
Statesville, NC 28625-1930
Phone
(704) 838-7102
NPI assigned
May 2, 2024
Last updated
Jul 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Saad Ehtisham
Title
SVP & President Nhpmc & GCM
Phone
(704) 384-9656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU Primary

Addresses

Primary practice location

218 Old Mocksville Rd
Statesville, NC 28625-1930

Mailing address

101 N Cherry St Ste 600
Winston Salem, NC 27101-4013
Phone (336) 277-1604

Other names 1

  • Davis Regional Medical Center - Psych Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davis Regional Medical Center - Psych Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1851148308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N CHERRY ST STE 600",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014013",
            "telephone_number": "336-277-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-838-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH DAVIS MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "EHTISHAM",
        "authorized_official_first_name": "SAAD",
        "authorized_official_title_or_position": "SVP & PRESIDENT NHPMC & GCM",
        "authorized_official_telephone_number": "704-384-9656"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davis Regional Medical Center - Psych Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.