Organization Active NPI

Novant Health Wilmington Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
National Provider Identifier
1962080853
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER LLC
Practice address
1520 Physicians Dr Ste a
Wilmington, NC 28401-7356
Phone
(910) 662-8400
Fax
(910) 662-8361
NPI assigned
Mar 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Authorized official

Name
Andrea Smith-Jones
Title
VP Clinical Operations (ASC)
Phone
(336) 277-8757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1520 Physicians Dr Ste a
Wilmington, NC 28401-7356

Mailing address

2085 Frontis Plaza Blvd FL 3
Winston Salem, NC 27103-5614
Phone (336) 277-8757

Other names 1

  • NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210621000298 NC Part B Supplier - Ambulatory Surgical Center 2567871601 Practice locations: Wilmington, NC

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Novant Health Wilmington Endoscopy Center LLCCCN 34C0001151
Medicare certification status
ActiveFrom the Provider of Services file

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
34D2050063Novant Health Wilmington Endoscopy Center1520 Physicians Drive, Wilmington, NC 28401Certificate of waiverNov 18, 2026

National Provider Directory

National Provider Directory

Locations

1520 Physicians Dr
Ste A
Wilmington, NC 28401
Phone (910) 662-8278

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780185600000",
    "number": "1962080853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD FL 3",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "336-277-8757",
            "fax_number": "336-718-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 PHYSICIANS DR STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017356",
            "telephone_number": "910-662-8400",
            "fax_number": "910-662-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A",
        "authorized_official_last_name": "SMITH-JONES",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "VP CLINICAL OPERATIONS (ASC)",
        "authorized_official_telephone_number": "336-277-8757"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; 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.