NPIMap

Organization Active NPI

Foundation Health Systems, Corp.

Doing business as Novant Health Neurologic Rehabilitation Center

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Winston Salem, NC
National Provider Identifier
1932723616
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X
Legal business name
FOUNDATION HEALTH SYSTEMS, CORP.
Doing business as
Novant Health Neurologic Rehabilitation Center
Practice address
190 Kimel Park Dr Ste 139
Winston Salem, NC 27103-6946
Phone
(336) 718-6931
NPI assigned
May 29, 2020
Last updated
May 29, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
FOUNDATION HEALTH SYSTEMS, CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Authorized official

Name
Shala Davis
Title
Enrollment Manager
Phone
(704) 316-7845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X NU Primary

Addresses

Primary practice location

190 Kimel Park Dr Ste 139
Winston Salem, NC 27103-6946

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other names 1

  • Novant Health Neurologic Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Salem MRI Center30 organizations share this tax ID, including this one
Part of
Salem MRI Center

Other organizations with this tax ID 29

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

View all 29

Locations

190 Kimel Park Dr
Ste 139
Winston Salem, NC 27103
Phone (336) 277-2225

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1932723616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 KIMEL PARK DR STE 139",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-718-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION HEALTH SYSTEMS, CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUNDATION HEALTH SYSTEMS, CORP.",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "704-316-7845"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Neurologic Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.