NOVANT MEDICAL GROUP, INC. (NPI# 1043340557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043340557 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH BLAKENEY FAMILY PHYSICIANS |
| Practice Address |
5815 Blakeney Park Dr Suite 200 Charlotte NC 28277-5731 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165080 |
| Practice Fax Number | 7043165085 |
| Mailing Telephone | 7043165080 |
| Mailing Fax Number | 7043165085 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2013-06-28 |
| Authorized Official Name | GEOFFREY K GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043847606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5906264 | 05 | |
| NC | BCBS-NC | 019C1 | 01 |
| Other Name | Type Code |
|---|---|
| Novant Health Blakeney Family Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033723531 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy Ste 320, Matthews, NC 28105-2389 | 2020-09-02 |
| 1346868155 | Novant Medical Group, Inc. | Family Medicine | 106 Corporate Park Dr Ste 200, Mooresville, NC 28117-7134 | 2020-07-08 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1932725124 | Novant Medical Group, Inc. | Internal Medicine | 125 Queens Rd Ste 510, Charlotte, NC 28204-3215 | 2020-06-23 |
| 1922645571 | Novant Medical Group, Inc. | Surgery | 6324 Fairview Rd Ste 420, Charlotte, NC 28210-3372 | 2019-12-03 |
| 1437706256 | Novant Medical Group, Inc. | Physical Therapist | 11202 Harris Rd, Huntersville, NC 28078-7633 | 2019-08-26 |
| 1336795137 | Novant Medical Group, Inc. | Surgery | 3515 W Market St Ste 310, Greensboro, NC 27403-4438 | 2019-08-16 |
| 1104472125 | Novant Medical Group, Inc. | Neurological Surgery | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-15 |
| 1649824954 | Novant Medical Group, Inc. | Family Medicine | 6555 Kee Lane, Harrisburg, NC 28075-7463 | 2019-07-25 |
| 1285287185 | Novant Medical Group, Inc. | Lactation Consultant, Non-RN | 6324 Fairview Rd Ste 435, Charlotte, NC 28210-4278 | 2019-07-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NOVANT MEDICAL GROUP, INC. | 200 Hawthorne Ln, Charlotte, NC 28204-2515 |
| Street Address |
5815 BLAKENEY PARK DR SUITE 200 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-5731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417943135 | Malgorzata Anna Brown | Family Medicine | 5815 Blakeney Park Dr, Suite 200, Charlotte, NC 28277-5731 | 2005-09-27 |
| 1093055303 | Olga Samplawski | Physician Assistant | 5815 Blakeney Park Dr, Suite 200, Charlotte, NC 28277-5731 | 2013-02-22 |
| 1093076184 | David Earl Small Jr. | Family Medicine | 5815 Blakeney Park Dr, Suite 200, Charlotte, NC 28277-5731 | 2012-06-05 |
| 1114151750 | Melissa H Ratliff | Family Medicine | 5815 Blakeney Park Dr, Suite 200, Charlotte, NC 28277-5731 | 2009-05-12 |
| 1285868117 | Augustus Garland Parker Iv | Family Medicine | 5815 Blakeney Park Dr, Suite 200 B, Charlotte, NC 28277-5731 | 2009-05-06 |
| 1457557548 | Benjamin James Missick | Family Medicine | 5815 Blakeney Park Dr, Suite 200b, Charlotte, NC 28277-5731 | 2007-06-25 |
| 1063465953 | Samuel J Swad | Family Medicine | 5815 Blakeney Park Dr, Suite 200, Charlotte, NC 28277-5731 | 2006-05-19 |
| 1598742603 | Tonya S Mcleod | Dermatology | 5815 Blakeney Park Dr, Suite 100, Charlotte, NC 28277-5731 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745985 | Alegis Care - North Carolina PC | Family Medicine | 11016 Rushmore Dr Ste 300, Charlotte, NC 28277-3651 | 2020-09-18 |
| 1902411077 | Carolina Medical Partners Pllc | Family Medicine | 10535 Flennigan Way, Charlotte, NC 28277-1417 | 2020-09-15 |
| 1083226906 | Relymd Medical Group Nc, Pllc | Family Medicine | 212 S Tryon St Ste 1000, Charlotte, NC 28281-0001 | 2020-08-21 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1881223139 | Renew Health and Wellness | Family Medicine | 9010 Glenwater Dr Ste 102, Charlotte, NC 28262-8593 | 2020-04-07 |
| 1164052957 | Partners In Integrated Healthcare & Wellness Pllc | Family Medicine | 9414b Albemarle Rd, Charlotte, NC 28227-3346 | 2020-01-21 |
| 1578103636 | Madelyn Laine Eudy | Family Medicine | 15640 Don Lochman Ln Ste A, Charlotte, NC 28277-4793 | 2020-01-07 |
| 1518514686 | L'renda Arkie Adams | Family Medicine | 8724 Bodkin Ct, Charlotte, NC 28215-7356 | 2019-08-22 |
| 1952956419 | Heather Marie Anderson | Family Medicine | 6404 Albemarle Rd Ste J&k, Charlotte, NC 28212-3800 | 2019-08-01 |
| 1003460213 | Companion Health, Pllc | Family Medicine | 5029 Lady Fern Cir, Charlotte, NC 28211-4182 | 2019-07-25 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.