NOVANT MEDICAL GROUP, INC. (NPI# 1275025884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275025884 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH MEMORY CARE |
| Practice Address |
1730 Kernersville Medical Pkwy Ste 203 Kernersville NC 27284-7198 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3367187300 |
| Practice Fax Number | 3367187309 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |
| 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 Memory 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 |
1730 KERNERSVILLE MEDICAL PKWY STE 203 |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-7198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750593729 | Michaux Renata Kilpatrick | Neurological Surgery | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284 | 2007-05-04 |
| 1093200248 | Omobolawa Oreoluwa Olagoke | Nurse Practitioner | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284 | 2018-06-28 |
| 1275911612 | Novant Medical Group. Inc. | Psychiatry & Neurology | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284-7198 | 2015-05-18 |
| 1518303981 | Stephen H Cockburn | Psychiatry & Neurology | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284 | 2013-05-13 |
| 1376864488 | John Christopher Morris | Psychiatry & Neurology | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284-7198 | 2010-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| 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 |
|---|---|---|---|---|
| 1275911612 | Novant Medical Group. Inc. | Psychiatry & Neurology | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284-7198 | 2015-05-18 |
| 1518303981 | Stephen H Cockburn | Psychiatry & Neurology | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284 | 2013-05-13 |
| 1528322617 | Novant Medical Group, Inc | Psychiatry & Neurology | 1471 Jag Branch Blvd Ste 105, Kernersville, NC 27284-6956 | 2012-07-03 |
| 1255636775 | Regional Physicians LLC | Psychiatry & Neurology | 280 Broad St, Ste.b, Kernersville, NC 27284-2796 | 2011-01-13 |
| 1376864488 | John Christopher Morris | Psychiatry & Neurology | 1730 Kernersville Medical Pkwy Ste 203, Kernersville, NC 27284-7198 | 2010-06-13 |
| 1962681692 | Christine Louise Hagen | Psychiatry & Neurology | 1471 Jag Branch Blvd Ste 105, Kernersville, NC 27284-6956 | 2007-10-30 |
| 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 | KERNERSVILLE |
| Zip Code | 27284 |
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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.