Novant Health Medical Group, LLC
Organization Active NPI Surgery Physician · Rural Hall, NC
NPI 1932086709 · NPPES record last updated Aug 21, 2025
Key facts
- NPI
- 1932086709
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Practice address
- 648 Almondridge Dr
Rural Hall, NC 27045-9887 - Phone
- (336) 277-6300
- Fax
- (336) 277-6309
- NPI assigned
- Aug 21, 2025
- Organization subpart
- No
Authorized official
- Name
- Leea Jeanine Walton
- Title
- Enrollment Manager
- Phone
- (336) 515-7085
Corporate family (same tax ID) 24
Practitioners 2
-
Jodi Ann Arreguin, PA-C
-
David Dorenfeld, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000692 | NC | Part B Supplier - Clinic/Group Practice | 1153234893 |
Receives reassigned benefits from 3,607 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Presbyterian Inpt Care
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
648 Almondridge Dr
Rural Hall, NC 27045-9887
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 277-6300
Other names
- Novant Health Breast Surgery
Other providers in Rural Hall, NC
- New Beginnings: a New Start LLC
- Nicole Speeney Nutrition LLC
- Paul Walter Nienaber
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Virginia L Orosz
- Liliana Pantea
- Paul W. Nienaber, OD, PA
- Connie Perry
- Pioneer Health Services of Stokes County, Inc.
All providers in Rural Hall, NC · Surgery Physician 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 Aug 21, 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.