NOVANT MEDICAL GROUP, INC (NPI# 1104162932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104162932 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH DEVELOPMENTAL & BEHAVIORAL PEDIATRICS |
| Practice Address |
6331 Carmel Rd Ste 102 Charlotte NC 28226 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043840567 |
| Practice Fax Number | 7043840568 |
| Mailing Telephone | 7043840567 |
| Mailing Fax Number | 7043840568 |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2018-09-04 |
| Authorized Official Name | MR. GEOFFREY K. GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043161155 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Developmental & Behavioral Pediatrics | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3135 Springbank Ln, Suite 100, Charlotte, NC 282263360 | 7043164445 | 7043164446 |
| 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 |
6331 CARMEL RD STE 102 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255375424 | Augustus G Parker IIi | Obstetrics & Gynecology | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2006-06-16 |
| 1083220339 | Ashleigh Starnes | Nurse Practitioner | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2020-09-22 |
| 1447877931 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2020-06-30 |
| 1871148288 | Felicia Hunt | Nurse Practitioner | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2019-08-04 |
| 1669032231 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2019-06-17 |
| 1609346709 | Allison M Lachowitz | Dietitian, Registered | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2018-11-30 |
| 1316417959 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-11-27 |
| 1699243485 | Forsyth Medical Group, LLC | Obstetrics & Gynecology | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2018-11-09 |
| 1679050017 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-07-27 |
| 1891271482 | Novant Medical Group, Inc. | Psychiatry & Neurology | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881689362 | Barbara Elizabeth Kissam | Pediatrics | 1900 Randolph Rd, Suite 1010, Charlotte, NC 28207-1122 | 2005-09-12 |
| 1801343793 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 601, Charlotte, NC 28204-3261 | 2016-09-08 |
| 1942637319 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 2608 E 7th St, Suite B, Charlotte, NC 28204-4375 | 2013-10-01 |
| 1144580754 | Carolinas Medical Center-northeast | Pediatrics | 4501 Cameron Valley Pkwy, Suite 301-b, Charlotte, NC 28211-4297 | 2012-05-17 |
| 1306987185 | Yasmin Senturias | Pediatrics | 2608 E 7th St, Suite B, Charlotte, NC 28204-4375 | 2007-02-12 |
| 1275627812 | Tsehaiwork Fenikile | Pediatrics | 2608 E 7th St, Suite B, Charlotte, NC 28204-4375 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548746365 | Kassondra Amada Shoemaker Brino | Pediatrics | 307 S Salem St Ste 100, Apex, NC 27502-1845 | 2018-07-15 |
| 1164949814 | Moses Cone Physician Services, Inc. | Pediatrics | 301 E Wendover Ave Ste 311, Greensboro, NC 27401-1210 | 2017-08-24 |
| 1821474628 | Melissa Thingvoll Md Pllc | Pediatrics | 7 Yorkshire St Ste 101, Asheville, NC 28803-2798 | 2015-08-04 |
| 1053445130 | Barbara Nan Samuels | Pediatrics | 108 W Fire Tower Rd Ste B, Ecu Pediatrics Autism Center, Winterville, NC 28590-8408 | 2007-03-14 |
| 1396823498 | Patricia Dockery Weavil | Pediatrics | 4805 Seward Rd, Pfafftown, NC 27040-9450 | 2006-11-02 |
| 1780782805 | Jean Charlotte Smith | Pediatrics | 10 Sunnybrook Road, Wake County Human Services, Raleigh, NC 27610-1808 | 2006-09-20 |
| 1528060209 | Arne John Anderson | Pediatrics | 108 W Fire Tower Rd, Winterville, NC 28590-8371 | 2005-08-12 |
| 1104479708 | Novant Medical Group Inc | Pediatrics | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2019-07-23 |
| 1508426370 | Novant Medical Group Inc | Pediatrics | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2019-06-14 |
| 1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
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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.