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NOVANT HEALTH GATEWAY FAMILY MEDICINE
NPI 1073076956
Family Medicine in Winston Salem, NC

Active since April 09, 2019CLIA 34D1080075 · Waiver
390 W SALEM AVE, WINSTON SALEM, NC 27101(336) 721-2375(336) 721-2394 Get Directions Write a Review

NPPES record last updated: July 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2024, Jul 10, 2023, Aug 18, 2021 and 1 more (4 updates tracked since 2019).

About Novant Health Gateway Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVANT HEALTH GATEWAY FAMILY MEDICINE (NPI 1073076956) is a healthcare organization registered as a family medicine in Winston Salem, North Carolina and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through March 31, 2027 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1073076956
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address390 W SALEM AVEWinston Salem, NC 27101-5861
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(336) 721-2375
Fax(336) 721-2394
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateApril 9, 2019
Last NPPES UpdateJuly 9, 20244 updates tracked since enumeration
NPPES CertifiedJuly 9, 2024
✔ NPI 1073076956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
390 W SALEM AVE, Winston Salem, NC 27101
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Other Names 1

Doing Business AsNovant Health Gateway Family Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D1080075

Novant Health Gateway Family Medicine · Winston-Salem, NC
Active · expires Mar 31, 2027
CLIA Number34D1080075
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorMr. Phillip Kelley
Laboratory Phone(336) 721-2375
Laboratory LocationNovant Health Gateway Family Medicine390 Salem Avenue, Winston-Salem, NC 27101
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JONATHAN CHARLES LEE MACK MD
Family Medicine
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
PHILLIP ANTONIO KELLEY PA-C
Physician Assistant
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
MR. ANDREW SCOTT HENDERSON PA-C
Physician Assistant
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
DANIELLE EMILY STADLER PA-C
Physician Assistant
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
MAGGIE ELIZABETH FOSTER PA-C
Physician Assistant
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
NOVANT MEDICAL GROUP, INC.
Family Medicine
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
MRS. ANTONETTE RHONDA FARMER SCOTT FNP
Nurse Practitioner
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375
MRS. KRISTEN E RINKENBERG PA
Physician Assistant
390 W SALEM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 721-2375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Novant Health Medical Group, LLC's NPI number?

The NPI number for Novant Health Medical Group, LLC is 1073076956. It was assigned to this organization in the NPPES registry on April 9, 2019. The provider is doing business as Novant Health Gateway Family Medicine.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 390 W Salem Ave, Winston Salem, NC 27101. The listed phone number is (336) 721-2375.

What is Novant Health Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Novant Health Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1080075) is associated with this NPI, valid through March 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Novant Health Medical Group, LLC accept?

Health plans from Blue Cross and Blue Shield of NC list Novant Health Medical Group, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Novant Health Medical Group, LLC was last updated on July 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.