NPIMap

Organization Active NPI

Novant Health Enterprises Imaging, LLC

  • Diagnostic Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1932994571
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
Practice address
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(704) 323-3670
Fax
(336) 794-3598
NPI assigned
Apr 14, 2025
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 11

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

Corporate family (same tax ID) 17

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

View all 17

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 68

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20260625000664 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3072095546 Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Enterprises Imaging LLC (18 organizations share this tax ID)

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

170 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (704) 323-3670

Other names 1

NPPES NPI Registry
  • Novant Health Imaging Park & Trail Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 6, 2025.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1932994571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "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": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "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 Park & Trail",
            "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 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.