NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
NPI 1629738505
Family Medicine in Jacksonville, NC
About Novant Health Medical Group Coastal Region, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC (NPI 1629738505), doing business as Novant Health Family Medicine Jacksonville, is a healthcare organization registered as a family medicine in Jacksonville, North Carolina and active in the NPI registry since December 2021. The organization lists Shala Davis, Rcs Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Novant Health Medical Group Coastal Region, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
710Medicare enrollment records show 710 clinicians reassign Medicare billing to Novant Health Medical Group Coastal Region, LLC, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 47
Nearest to this location (20)
See all 710Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Coastal Region, LLC's NPI number?
The NPI number for Novant Health Medical Group Coastal Region, LLC is 1629738505. It was assigned to this organization in the NPPES registry on December 20, 2021. The provider is doing business as Novant Health Family Medicine Jacksonville.
Where is Novant Health Medical Group Coastal Region, LLC located?
Novant Health Medical Group Coastal Region, LLC is located at 2000 Brabham Ave, Jacksonville, NC 28546. The listed phone number is (910) 376-3025.
What is Novant Health Medical Group Coastal Region, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Novant Health Medical Group Coastal Region, LLC enrolled in Medicare?
Yes. Novant Health Medical Group Coastal Region, LLC is registered in the Medicare PECOS enrollment system.
When is Novant Health Medical Group Coastal Region, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Novant Health Medical Group Coastal Region, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 710 clinicians in 47 Medicare specialties reassign their Medicare billing to Novant Health Medical Group Coastal Region, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (191), Hospitalist (87) and Family Practice (56). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Novant Health Medical Group Coastal Region, LLC was last updated on December 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Novant Health Medical Group Coastal Region, Llc · NPI 1629738505
Family Medicine organization in Jacksonville, North Carolina. Organization record, active in the CMS NPPES registry since December 20, 2021.
## Identity
- **NPI:** 1629738505 (Entity type: Organization)
- **Enumerated:** December 20, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Novant Health Family Medicine Jacksonville (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Shala Davis, RCS MANAGER
## Practice location
- **Address:** 2000 BRABHAM AVE, Jacksonville, NC 28546-0201
- **Phone:** (910) 376-3025 · **Fax:** (910) 362-9123
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, North Carolina, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 710 clinicians in 47 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (191), Hospitalist (87), Family Practice (56); 6 practice within 10 miles; [full list](https://npiprofile.com/npi/1629738505/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 20, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1629738505) · Data from the CMS NPPES public registry.