NPIMap

Organization Active NPI

Novant Health Enterprises Imaging, LLC

Doing business as Novant Health Imaging Kernersville West

  • Diagnostic Radiology Physician
  • Kernersville, NC
National Provider Identifier
1891580429
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NOVANT HEALTH ENTERPRISES IMAGING, LLC
Doing business as
Novant Health Imaging Kernersville West
Practice address
445 Pineview Dr Ste 220
Kernersville, NC 27284-3818
Phone
(704) 323-3670
Fax
(336) 794-3598
NPI assigned
Apr 14, 2025
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Mr. Wade Collins
Title
VP of Novant Health Ventures
Phone
(423) 677-0679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

445 Pineview Dr Ste 220
Kernersville, NC 27284-3818

Mailing address

445 Pineview Dr Ste 220
Kernersville, NC 27284-3818
Phone (704) 323-3670

Other names 1

  • Novant Health Imaging Kernersville West Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260618002830 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3072095546 Practice locations: Kernersville, NC

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1101112Novant Health Imaging Kernersville445 Pineview Drive, Suite 100, Kernersville, NC 27284Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Enterprises Imaging LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 68

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.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1891580429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 PINEVIEW DR STE 220",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843818",
            "telephone_number": "704-323-3670",
            "fax_number": "336-794-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 PINEVIEW DR STE 220",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843818",
            "telephone_number": "704-323-3670",
            "fax_number": "336-794-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH ENTERPRISES IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "VP OF NOVANT HEALTH VENTURES",
        "authorized_official_telephone_number": "423-677-0679",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Imaging Kernersville West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.