NOVANT MEDICAL GROUP INC (NPI# 1205177045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205177045 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Practice Address |
11840 Southmore Dr Ste 201 Charlotte NC 28277-0785 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043849900 |
| Practice Fax Number | 7043849919 |
| Mailing Telephone | 7043847840 |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2018-01-18 |
| Authorized Official Name | MR. GEOFFREY KEITH GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043849900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1205355799 | Novant Medical Group Inc | Family Medicine | 16525 Holly Crest Ln Ste 250, Huntersville, NC 28078-4912 | 2017-09-15 |
| 1679090468 | Novant Medical Group Inc | Internal Medicine | 12311 Copper Way Ste 100, Charlotte, NC 28277-3643 | 2017-08-23 |
| 1003332016 | Novant Medical Group Inc | Internal Medicine | 10030 Gilead Rd Ste 344, Huntersville, NC 28078-7545 | 2017-08-22 |
| 1255709432 | Novant Medical Group Inc | Family Medicine | 19485 Old Jetton Road, Suite 100, Cornelius, NC 28031-6583 | 2015-09-04 |
| 1215326665 | Novant Medical Group Inc | Surgery | 819 N Atlantic Ave, Southport, NC 28461-3531 | 2015-01-22 |
| 1194113662 | Novant Medical Group Inc | Obstetrics & Gynecology | 1730 Kernersville Medical Parkway, Suite 104, Kernersville, NC 27284-7198 | 2015-01-06 |
| 1437556594 | Novant Medical Group Inc | Internal Medicine | 13 Medical Campus, Suite 102, Supply, NC 28462-4093 | 2014-12-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Novant Medical Group Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Novant Medical Group Inc. | 2085 Frontis Plaza Blvd, Winston Salem, North Carolina 27103 |
| Street Address |
11840 SOUTHMORE DR STE 201 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-0785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1740200047 | James B Jones | Internal Medicine | 6060 Piedmont Row Dr S Fl 10, Charlotte, NC 28287 | 2006-07-20 |
| 1962470666 | Estrelita Nancy Clavio-ziechmann | Internal Medicine | 10036 Park Cedar Dr, Suite A, Charlotte, NC 28210-8914 | 2006-03-09 |
| 1780974816 | Sailaja Allamneni | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2011-04-11 |
| 1669779583 | Anil Jotwani | Internal Medicine | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2011-02-14 |
| 1649590324 | Joshua Davis | Internal Medicine | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2010-06-04 |
| 1619293701 | John Wynne | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2010-04-14 |
| 1083843304 | Muhammad Rashad | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2009-07-08 |
| 1962658856 | Alfred Papali | Internal Medicine | 10650 Park Rd, Ste 300, Charlotte, NC 28210-8538 | 2008-08-12 |
| 1235390691 | Joshua Smith | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2008-06-18 |
| Find all providers in CHARLOTTE | ||||
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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.