MEDICARE: NOVANT HEALTH THOMASVILLE MEDICAL CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1922897008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVANT HEALTH THOMASVILLE MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	PO BOX 935983
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-5983
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 OLD LEXINGTON RD STE 106
Second Line	:
City	:	THOMASVILLE
State	:	NC
Zip	:	27360-3428
Country	:	US
Telephone Number	:	336-474-8921
Fax Number	:	336-474-8923

Authorized Official
Title or Position	:	ENROLLMENT MANAGER
Name	:	LEEA JEANINE WALTON
Credential	:
Telephone Number	:	704-316-6081

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	01/14/2026

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