NOVANT MEDICAL GROUP, INC. (NPI# 1104472125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104472125 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH BRAIN AND SPINE SURGERY |
| Practice Address |
3515 W Market St Ste 210 Greensboro NC 27403-4442 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043166493 |
| Practice Fax Number | 7043169859 |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-10-08 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | Y |
| Parent Organization Name | NOVANT MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Brain & Spine Surgery | Doing Business As Name - Organization |
| Novant Health Brain and Spine Surgery | 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 |
| 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 |
| 1477113462 | Novant Medical Group, Inc. | Family Medicine | 416 East 36th Street, Suite 200, Charlotte, NC 28205-1030 | 2019-06-20 |
| 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 |
3515 W MARKET ST STE 210 |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27403-4442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407403710 | Novant Medical Group Inc | Psychiatry & Neurology | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-21 |
| 1619524097 | Novant Medical Group Inc | Physical Medicine & Rehabilitation | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518581412 | Tina Tate | Nurse Practitioner | Behavioral Health Hospital, 700 Walter Reed Drive, Greensboro, NC 27403 | 2020-06-05 |
| 1609438514 | Gail Corneau | Psychologist | Uncg Psychology Clinic, 1100 West Market Street, Greensboro, NC 27403 | 2019-07-01 |
| 1528527298 | Kendall Austin Macdonald | Hearing Instrument Specialist | 2823 A Spring Garden St, Suite A, Greensboro, NC 27403 | 2019-03-13 |
| 1093292237 | Andrew Robertson | Pharmacist | 1903 W. Florida St, Greensboro, NC 27403 | 2018-07-20 |
| 1447778071 | Bac Developmental Program Inc | Day Training, Developmentally Disabled Services | 2203 Coliseum Blvd, Greensboro, NC 27403 | 2017-09-04 |
| 1144607128 | Waldo's Optical | Eyewear Supplier (Equipment, not the service) | 2500 Spring Garden St., Suite C, Greensboro, NC 27403 | 2015-04-29 |
| 1851703144 | Tedra Slade | Social Worker | 612 Pasteur Dr., Suite 300, Greensboro, NC 27403 | 2014-05-21 |
| 1336568807 | Brian Sninsky | Urology | Alliance Urology Specialists, Pa, 509 N. Elam Ave., 2nd Floor, Greensboro, NC 27403 | 2014-04-14 |
| 1003237785 | Peter Reich | Counselor | 907 Englewood St, Greensboro, NC 27403 | 2013-12-23 |
| 1508295429 | Alexander Wilson Lpc Inc | Counselor | 3719 West Market Street, Suite B, Greensboro, NC 27403 | 2013-11-01 |
| Find all providers in zip 27403 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588921969 | Thomas Ostergard | Neurological Surgery | 1130 N Church St Ste 200, Greensboro, NC 27401-1041 | 2012-04-23 |
| 1154822468 | Katelyn Welch | Neurological Surgery | 2105 Braxton Ln Ste 101, Greensboro, NC 27408-2862 | 2018-02-22 |
| 1750750238 | Carolina Neurosurgery & Spine Associates, Pa | Neurological Surgery | 1130 N Church St, Suite 200, Greensboro, NC 27401-1038 | 2015-09-15 |
| 1255609368 | Jeffrey Segal | Neurological Surgery | 3300 Battleground Ave, Ste 410, Greensboro, NC 27410-2465 | 2011-12-02 |
| 1417262692 | Neelesh Nundkumar | Neurological Surgery | 1130 N Church St, Suite 200, Greensboro, NC 27401-1038 | 2010-08-12 |
| 1275750150 | Gustav Arthur Blomquist Jr. | Neurological Surgery | 1110 Sunset Dr, Greensboro, NC 27408-7214 | 2007-04-20 |
| 1508857749 | Henry Joseph Elsner | Neurological Surgery | 1130 N Church St, Suite 200, Greensboro, NC 27401-1038 | 2005-11-04 |
| 1558352831 | Joseph David Stern | Neurological Surgery | 1130 N Church St, Suite 200, Greensboro, NC 27401-1038 | 2005-11-04 |
| 1942291133 | Jeffrey David Jenkins | Neurological Surgery | 1130 N Church St, Suite 200, Greensboro, NC 27401-1038 | 2005-11-04 |
| 1275524605 | Ernesto Miguel Botero | Neurological Surgery | 1130 N Church St, Suite 200, Greensboro, NC 27401-1038 | 2005-11-03 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27403 |
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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.