NOVANT MEDICAL GROUP, INC (NPI# 1043666225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043666225 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH CAROLINA UROLOGICAL ASSOCIATES |
| Practice Address |
100 Johnson Ridge Medical Park Elkin NC 28621-2400 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3362452100 |
| Mailing Telephone | 3362452100 |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-08-10 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043849672 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Carolina Urological Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
| 1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 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 |
100 JOHNSON RIDGE MEDICAL PARK |
| City | ELKIN |
| State | NC |
| Zip Code | 28621-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710966718 | David J Bohle | Internal Medicine | 100 Johnson Ridge Medical Park, Elkin, NC 28621-2400 | 2006-01-10 |
| 1073662888 | Saiyyed Oomer Aziem | Internal Medicine | 100 Johnson Ridge Medical Park, Elkin, NC 28621-2400 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553692 | Carenet, Inc. | Counselor | 1288 C.b. Eller School Road, Elkin, NC 28621 | 2019-11-19 |
| 1386104776 | North Bridge Physio and Sports Performance | Clinic/Center | 1605 North Bridge Street, Elkin, NC 28621 | 2019-03-21 |
| 1609389238 | Rebecca Anne Dumas | Physical Therapist | 145 Valleybrook Dr, Elkin, NC 28621 | 2017-11-06 |
| 1922547744 | Lori Barker | Clinical Nurse Specialist | 124, Samaritan's Ridge Road, Elkin, NC 28621 | 2017-02-13 |
| 1205061256 | Hugh Chatham Memorial Hospital, Inc | Internal Medicine | 520 Chatham Medical Park, Elkin, NC 28621 | 2009-05-20 |
| 1093909236 | Elkin Obstetrics and Gynecology, Pllc | Obstetrics & Gynecology | 101 A Eldon Parks Dr., Elkin, NC 28621 | 2007-08-30 |
| 1497956205 | Nayana Abrol | Internal Medicine | 180 Parkwood Drive, Hugh Chatham Memorial Hospital, Elkin, NC 28621 | 2007-05-30 |
| 1104950765 | Dgis Elkin Inc Dba Chatham Nursing and Rehabilitation | Skilled Nursing Facility | 700 Johnson Ridge Road, Elkin, NC 28621 | 2007-03-15 |
| 1093860777 | Carolina Select Home Care, LLC. | Home Health | 948-b Johnson Ridge Rd., Elkin, NC 28621 | 2007-01-24 |
| 1922160761 | Piedmont Department of Urology, Pllc | Urology | 350 Johnson Ridge Medical Park, Elkin, NC 28621 | 2006-12-15 |
| Find all providers in zip 28621 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922160761 | Piedmont Department of Urology, Pllc | Urology | 350 Johnson Ridge Medical Park, Elkin, NC 28621 | 2006-12-15 |
| 1790767382 | Dominick John Carbone Jr. | Urology | 200 Johnson Ridge Medical Park, Elkin, NC 28621-2443 | 2005-11-18 |
| 1679939565 | Novant Medical Group Inc | Urology | 124 Samaritans Ridge Rd, Elkin, NC 28621-2452 | 2016-01-07 |
| 1053597856 | Hugh Chatham Memorial Hospital Inc | Urology | 100 Chatham Medical Park, Elkin, NC 28621-2445 | 2008-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528673423 | Meredith Abernethy | Urology | 140 Kimel Park Dr # 100, Winston Salem, NC 27103-6184 | 2020-09-09 |
| 1942833678 | Joshua Daniel Howell | Urology | 10650 Park Rd Ste 320, Charlotte, NC 28210-8543 | 2020-02-21 |
| 1144887019 | Shuo Liu | Urology | Department of Urology Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2019-05-25 |
| 1427563725 | Hifu Prostate Services, LLC | Urology | 4108 Park Rd Ste 205, Charlotte, NC 28209-2260 | 2017-12-08 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1184163883 | Dlp Central Carolina Medical Group LLC | Urology | 1139 Carthage St Ste 110-b, Sanford, NC 27330-4111 | 2017-02-15 |
| 1578007225 | Cumberland County Hospital System Inc | Urology | 805 Tilghman Dr, Suite A, Dunn, NC 28334-5887 | 2016-12-15 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1588019152 | Murphy Medical Center, Inc. | Urology | 75 Medical Park Ln Ste A, Murphy, NC 28906-6673 | 2016-05-02 |
| 1427446723 | Regional Physicians LLC | Urology | 217- 218 Gatewood Ave, High Point, NC 27262-4877 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
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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.