NOVANT MEDICAL GROUP, INC. (NPI# 1265924468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265924468 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH NEUROLOGY AND SLEEP |
| Practice Address |
152 E Kinderton Way Ste 101 Bermuda Run NC 27006 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043847680 |
| Mailing Telephone | 3368933180 |
| Mailing Fax Number | 3368933189 |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-08-28 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Neurology and Sleep | 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 |
152 E KINDERTON WAY STE 101 |
| City | BERMUDA RUN |
| State | NC |
| Zip Code | 27006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144406 | Emily Church Spencer | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2020-04-28 |
| 1124511985 | Novant Medical Group, Inc. | Internal Medicine | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-07 |
| 1902398985 | Novant Medical Group, Inc | Neurological Surgery | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2018-06-05 |
| 1326466574 | Kent Cochran | Anesthesiology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2014-04-04 |
| 1124290283 | Kelli Nichols Case | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2008-03-29 |
| 1750585170 | Dittana Phoncharoensri | Psychiatry & Neurology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811567 | Venessa Brunt | Home Health | 271 Orchard Park Drive, Advance, NC 27006 | 2020-08-17 |
| 1730707928 | Dara Elzena Green | Physical Therapist | 142 Hollybrook Dr, Advance, NC 27006 | 2020-07-14 |
| 1104339084 | Mark Curry Maynard | Registered Nurse | 125 W Robin Dr, Advance, NC 27006 | 2017-11-14 |
| 1457781585 | Christa Cook | Physical Therapist | 316 N Carolina 801, Advance, NC 27006 | 2013-11-27 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1073745485 | Digestive Health Specialists, Pa | Internal Medicine | 112 Kinderton Blvd, Advance, NC 27006 | 2009-08-18 |
| 1114101078 | Dr. Todd Carter D.d.s | Dentist | 123 Nc Highway 801 S. #c-100, Advance, NC 27006 | 2007-12-27 |
| 1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
| 1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
| 1104927987 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 260 Highway 801, Advance, NC 27006 | 2006-09-26 |
| Find all providers in zip 27006 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574706 | Nandigam Neurology, LLC | Psychiatry & Neurology | 10 Doctors Cir Ste 1, Supply, NC 28462-4218 | 2020-09-30 |
| 1033738299 | Catawba Valley Medical Group Inc | Psychiatry & Neurology | 3246 6th Ave Se Ste 101, Hickory, NC 28602-8335 | 2020-04-08 |
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1952886582 | John Messenheimer | Psychiatry & Neurology | 55 Hermitage Ln, Moncure, NC 27559-9670 | 2018-09-28 |
| 1578056057 | Novant Medical Group, Inc. | Psychiatry & Neurology | 15033 Ballancroft Pkwy Ste 200, Charlotte, NC 28277-4944 | 2018-06-11 |
| 1619474012 | Jamie Hannah Rose Aldridge | Psychiatry & Neurology | 1121 N Church Street, Greensboro, NC 27401 | 2018-04-11 |
| 1811417835 | Arvind Muralimohan Gomadam | Psychiatry & Neurology | 1492 Rymco Dr, Winston Salem, NC 27103 | 2017-06-21 |
| 1932637568 | Irena Dujmovic Basuroski | Psychiatry & Neurology | 194 Finley Golf Course Road, Suite 200, Chapel Hill, NC 27517 | 2017-05-26 |
| 1750838702 | Zuleyma Enid Toledo-nieves | Psychiatry & Neurology | Unc Hospitals Department of Neurology, 170 Manning Drive, Cb#7025, Chapel Hill, NC 27599-7025 | 2016-09-07 |
| 1659722593 | Arfeen Geriatric Care Pllc | Psychiatry & Neurology | 2961 Crouse Ln Ste D, Burlington, NC 27215-8833 | 2016-06-22 |
| Find all providers with the same taxonomy | ||||
| City | BERMUDA RUN |
| Zip Code | 27006 |
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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.