NOVANT MEDICAL GROUP, INC. (NPI# 1174169593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174169593 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
6324 Fairview Rd Ste 310 Charlotte NC 28210-4172 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043166565 |
| Practice Fax Number | 7043166560 |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2019-11-20 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Senior Care | 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 |
6324 FAIRVIEW RD STE 310 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-4172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184609752 | Tammy Lynne Johnson-wait | Registered Nurse | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2005-12-07 |
| 1184267007 | Novant Medical Group, Inc. | Psychiatry & Neurology | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2019-10-23 |
| 1841773892 | The Presbyterian Hospital | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2018-09-14 |
| 1649762451 | Tarra Marsh Boyd | Nurse Practitioner | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2018-06-06 |
| 1063618312 | Asaad Elsayed Ahmed | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2007-06-25 |
| 1235248246 | Mark Anthony Pippenger | Psychiatry & Neurology | 6324 Fairview Rd Ste 310, Charlotte, NC 28210 | 2006-08-30 |
| 1194832691 | Violeta Mihailescu | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861675613 | Nichole Marie Arkfeld | Internal Medicine | 3506 West Tyvola Road, Charlotte, NC 28208 | 2007-12-14 |
| 1205811080 | Juliana Millan | Internal Medicine | 8601 University East Dr, Charlotte, NC 28213-4353 | 2005-12-14 |
| 1508394750 | Charlotte Neuroscience Foundation | Internal Medicine | 300 Billingsley Rd Ste 108, Charlotte, NC 28211-3091 | 2017-06-01 |
| 1578829313 | Bhavinkumar Patel | Internal Medicine | 101 E Wt Harris Blvd, Building 1000 Ste 1110, Charlotte, NC 28262-3485 | 2012-04-05 |
| 1093081762 | New Hope Specialty Clinic | Internal Medicine | 3101 Latrobe Dr, Charlotte, NC 28211-4849 | 2012-03-28 |
| 1679736631 | Deanna Mangieri | Internal Medicine | 101 E Wt Harris Blvd, Building 1000 Ste 1110, Charlotte, NC 28262-3485 | 2008-07-09 |
| 1659459659 | Anthony Caprio | Internal Medicine | 2001 Vail Ave, Ste 400, Charlotte, NC 28207-1248 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205324449 | Innovative Healthcare Management Provider Group | Internal Medicine | 19401 Old Jetton Rd Ste 100, Cornelius, NC 28031-6575 | 2018-04-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1710480066 | Novant Medical Group, Inc. | Internal Medicine | 1450 Matthews Township Pkwy Ste 400, Matthews, NC 28105-5336 | 2018-03-13 |
| 1710306204 | Serena Wong | Internal Medicine | 40 Duke Medicine Cir Rm 2512, Durham, NC 27710-2527 | 2014-04-10 |
| 1033554811 | Ben Adam Blomberg | Internal Medicine | 6011 Farrington Rd, Suite 101, Chapel Hill, NC 27517-8168 | 2013-05-07 |
| 1881941706 | Robert Sullivan | Internal Medicine | 294 Highview Dr, Chapel Hill, NC 27517-7911 | 2012-08-09 |
| 1780974584 | Claire Kathryn Larson | Internal Medicine | 5003 Old Clinic Bldg Cb 7550, Chapel Hill, NC 27599-2204 | 2011-04-13 |
| 1316236649 | Mia Yang | Internal Medicine | Internal Medicine Section On Gerontology &, 1st Floor Sticht Center, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2011-04-07 |
| 1659673838 | Moses Cone Affiliated Physicians, Inc. | Internal Medicine | 1200 N Elm Street, Moses Cone Health System, Administrativeservices,ste201, Greensboro, NC 27401-1020 | 2010-11-22 |
| 1871821728 | Pamela Estelle Gutman | Internal Medicine | 189 Country Club Rd, Asheville, NC 28804 | 2009-12-03 |
| 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.