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NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
NPI 1710647698
Surgery - Pediatric Surgery in Wilmington, NC

Active since December 20, 2021
2131 S 17TH ST, WILMINGTON, NC 28401(910) 667-5830(910) 662-8909 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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 1710647698), doing business as Novant Health Pediatric Surgery, is a healthcare organization registered as a pediatric surgery in Wilmington, 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

NPI1710647698
Entity TypeOrganization
Primary Taxonomy2086S0120X
Legal Business NameNOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Location Address2131 S 17TH STWilmington, NC 28401-7407
Mailing AddressPo Box 936857Atlanta, GA 31193-6857
Phone(910) 667-5830
Fax(910) 662-8909
Organization SubpartNo
Authorized OfficialShala DavisRcs Manager · (704) 303-7517
Enumeration DateDecember 20, 2021
NPPES CertifiedDecember 14, 2021
✔ NPI 1710647698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
2131 S 17TH ST, Wilmington, NC 28401
Open in Google Maps ↗

Other Names 1

Doing Business AsNovant Health Pediatric Surgery

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 ›

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.

StateEnrollment IDDue date
StateNorth CarolinaEnrollment IDO20210408000285Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

710

Medicare 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, 129 practice at this address and 466 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 47

Nurse Practitioner191
Hospitalist87
Family Practice56
Internal Medicine50
Neurology43
Cardiovascular Disease (Cardiology)30
Obstetrics/Gynecology28
Gastroenterology24
39 other specialties201

Nearest to this location (20)

See all 710
James Adgent, MD
Hospitalist
NPI 1023039179
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOS✔ Accepts MedicareSame address
Hayley Afanador, MD
Hospitalist
NPI 1245505437
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOS✔ Accepts MedicareSame address
Lauren Anderson, DO
Internal Medicine
NPI 1306540075
2131 S 17TH ST
Wilmington, NC 28401
(910) 343-7000
✔ PECOS✔ Accepts MedicareSame address
Julie Andrews
Nurse Practitioner
NPI 1134505738
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-3984
✔ PECOSSame address
Shantanu Baghel, DO
Psychiatry
NPI 1134610983
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOS✔ Accepts MedicareSame address
Swaleh Bahamadi, MD
Medical Oncology
NPI 1649320144
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-3000
✔ PECOS✔ Accepts MedicareSame address
Heather Ballew, MSN-NNP
Nurse Practitioner
NPI 1104341213
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-2970
✔ PECOSSame address
William Beam, M.D.
Internal Medicine
NPI 1609215136
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-2606
✔ PECOS✔ Accepts MedicareSame address
John Bissett, DO
Family Practice
NPI 1588025746
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOS✔ Accepts MedicareSame address
Lindsey Buckingham, MD
Gynecological Oncology
NPI 1194138925
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-3000
✔ PECOS✔ Accepts MedicareSame address
Alyssa Cortese, MD
Hematology/Oncology
NPI 1053818120
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-3000
✔ PECOS✔ Accepts MedicareSame address
Kelsey Davis
Occupational Therapist in Private Practice
NPI 1255890521
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
Same address
Jeffrey Dehmer, MD
Pediatric Medicine
NPI 1669691168
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOSSame address
Danielle Dest, LCSW
Clinical Social Worker
NPI 1134659535
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7787
✔ PECOS✔ Accepts MedicareSame address
Michelle Fillion, MD
Surgical Oncology
NPI 1871758235
2131 S 17TH ST
Wilmington, NC 28401
(910) 772-9202
✔ PECOS✔ Accepts MedicareSame address
Michael Jaskolka, DDS, MD
Maxillofacial Surgery
NPI 1285835355
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-9402
✔ PECOS✔ Accepts MedicareSame address
Stacie Merritt, PT
Physical Therapist in Private Practice
NPI 1104668144
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7324
Same address
Timothy Weiner, MD
General Surgery
NPI 1902999196
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOSSame address
Benjamin Wiles, D.O.
Emergency Medicine
NPI 1467646471
2131 S 17TH ST
Wilmington, NC 28401
(910) 667-7000
✔ PECOS✔ Accepts MedicareSame address
Robert Williams, M.D.
Gastroenterology
NPI 1184651200
2131 S 17TH ST
Wilmington, NC 28401
(910) 772-9202
✔ PECOSSame address
See all 710 clinicians

Source: 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 1710647698. It was assigned to this organization in the NPPES registry on December 20, 2021. The provider is doing business as Novant Health Pediatric Surgery.

Where is Novant Health Medical Group Coastal Region, LLC located?

Novant Health Medical Group Coastal Region, LLC is located at 2131 S 17th St, Wilmington, NC 28401. The listed phone number is (910) 667-5830.

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

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

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, 129 practice at this address and 466 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Novant Health Medical Group Coastal Region, LLC accept?

Health plans from Blue Cross and Blue Shield of NC list Novant Health Medical Group Coastal Region, 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 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.