NOVANT MEDICAL GROUP, INC (NPI# 1063963080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063963080 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH UROLOGY |
| Practice Address |
1730 Kernersville Medical Pkwy Ste 303 Kernersville NC 27284-7198 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3365644430 |
| Practice Fax Number | 3369930826 |
| Mailing Telephone | (704) 384-9672 |
| Mailing Fax Number | 7043168725 |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | GEOFF 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 Urology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 445 Pineview Drive, Suite 200, Kernersville, NC 272843818 | 7043849672 | 7043168725 |
| 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 |
| 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 |
| 1831500354 | Novant Medical Group, Inc | Orthopaedic Surgery | Robinhood Medical Plaza Bldg 200, Winston Salem, NC 27106 | 2014-05-19 |
| 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 |
1730 KERNERSVILLE MEDICAL PKWY STE 303 |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-7198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326538984 | Forsyth Memorial Hospital, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2018-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| 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 |
|---|---|---|---|---|
| 1093798795 | David Legarde Mccullough | Urology | 500 Pineview Dr, Suite 101, Kernersville, NC 27284-3812 | 2005-11-28 |
| 1326538984 | Forsyth Memorial Hospital, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2018-05-18 |
| 1164881462 | Novant Medical Group Inc | Urology | 445 Pineview Dr, Suite 200, Kernersville, NC 27284-3818 | 2016-02-15 |
| 1841487006 | Carolina Urological Associates, P.a. | Urology | 445 Pineview Dr, Suite 230, Kernersville, NC 27284-3817 | 2007-10-01 |
| 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 |
| 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 |
| 1841695004 | Thomas Barnett Mobley IIi | Urology | 1413 Landfall Dr, Wilmington, NC 28405-4251 | 2014-10-30 |
| Find all providers with the same taxonomy | ||||
| City | KERNERSVILLE |
| Zip Code | 27284 |
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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.