NOVANT MEDICAL GROUP, INC (NPI# 1215454053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215454053 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH PEDIATRICS LAKE NORMAN |
| Practice Address |
10305 Hamptons Park Dr Ste 101 Huntersville NC 28078-7217 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043847834 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-24 |
| Authorized Official Name | GEOFFREY GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847834 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatrics Lake Norman | Doing Business As Name - Organization |
| 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 |
10305 HAMPTONS PARK DR STE 101 |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-7217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548269962 | Edward Conrad Robles | Physical Medicine & Rehabilitation | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2005-07-18 |
| 1528541026 | Chelsey Sisko | Physician Assistant | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2018-09-11 |
| 1316426398 | Noant Medical Group, Inc | Physical Medicine & Rehabilitation | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2018-08-09 |
| 1629563671 | Anastasia V. Slisenko | Nurse Practitioner | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078 | 2018-06-22 |
| 1376046581 | Novant Medical Group, Inc | Neurological Surgery | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2018-03-14 |
| 1104222785 | Ansley Walker Boutin | Physical Therapist | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2014-11-10 |
| 1285882688 | Novant Medical Group, Inc. | Psychiatry & Neurology | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2008-08-28 |
| 1790893006 | James W. Forrest | Physician Assistant | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2006-08-27 |
| 1578676979 | Charles Andrew Little | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078 | 2006-08-17 |
| 1295759983 | Michael Christopher Ficenec | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787718 | John M. Bakarich, Dds, Pllc | Dentist | 15810 Northcross Drive, Suite A, Huntersville, NC 28078 | 2020-07-14 |
| 1316587082 | Blake Allen Klessig | Chiropractor | 8936 Northpointe Executive Park Dr, Suite 195, Huntersville, NC 28078 | 2020-01-10 |
| 1922644830 | Steven James Underwood | Physical Therapist | Aldersgate Ccrc, 3800 Shamrock Drive, Charlotte, NC 28078 | 2019-11-26 |
| 1851856306 | Jessica Runnion | Behavior Technician | 14625 Reese Blvd, Apartment 208, Huntersville, NC 28078 | 2019-02-08 |
| 1568935401 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 111 Commerce Centre Drive, Suite 305, Huntersville, NC 28078 | 2019-01-03 |
| 1932691763 | Shakira Grier | Massage Therapist | 15905 Brookway Drive, Ste 4202, Huntersville, NC 28078 | 2018-06-06 |
| 1457850596 | Chudney Drew | Counselor | 10224 Hickorywood Hill Ave Ste 201, Huntersville, NC 28078 | 2018-02-05 |
| 1215457122 | Amy Nicole Castongia | Counselor | 10511 Drake Hill Dr, Huntersville, NC 28078 | 2017-06-21 |
| 1457714057 | Robin D Disbro | Registered Nurse | 6216 Colonial Garden Drive, Huntersville, NC 28078 | 2016-03-31 |
| 1144695545 | Huntersville H&r Ops Limited Partnership | Skilled Nursing Facility | 13835 Boren Street, Huntersville, NC 28078 | 2015-12-10 |
| Find all providers in zip 28078 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104908409 | Victoria Garriett-lampkin | Pediatrics | 6055 Latta Springs Cir, Huntersville, NC 28078-2333 | 2006-10-19 |
| 1295766079 | South Lake Pediatrics | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2006-07-06 |
| 1548608292 | Steven Hayes | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2013-06-04 |
| 1134412406 | Jill Hopkins | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2011-05-19 |
| 1164659322 | Karen Elizabeth Lewis | Pediatrics | 17220 Northcross Dr Ste 110, Huntersville, NC 28078-5076 | 2009-06-15 |
| 1083875355 | Mary Davis | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2008-06-19 |
| 1083784565 | Marcia Rubinos | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2006-11-09 |
| 1578676979 | Charles Andrew Little | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078 | 2006-08-17 |
| 1689698474 | Michelle Brody | Pediatrics | 9625 Northcross Center Ct, Suite 201, Huntersville, NC 28078-7348 | 2006-07-26 |
| 1932123726 | John Burcal | Pediatrics | 9625 Northcross Center Ct, Suite 201, Huntersville, NC 28078-7348 | 2006-07-26 |
| Find all providers in HUNTERSVILLE | ||||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
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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.