NOVANT MEDICAL GROUP INC (NPI# 1275795668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275795668 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | LAKE NORMAN NEONATOLOGY ASSOCIATES |
| Practice Address |
171 Fairview Rd Mooresville NC 28117-9500 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7046604390 |
| Practice Fax Number | 7046604399 |
| Mailing Telephone | 7043847840 |
| Mailing Fax Number | 7043847830 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |
| Authorized Official Name | MR. DINESH S PAI (VP OF OPERATIONS) |
| Authorized Official Telephone | 7043849113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lake Norman Neonatology Associates | Doing Business As Name - Organization |
| 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 |
171 FAIRVIEW RD |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28117-9500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518945880 | Jonathan Cowen | Internal Medicine | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2006-01-05 |
| 1851766885 | Lake Norman Inpatient Specialists | Hospitalist | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2015-12-02 |
| 1740557008 | Mooresville Ppm LLC | Pediatrics | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2011-11-30 |
| 1003190117 | Inpatient Care | Hospitalist | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2011-10-07 |
| 1053690560 | Lake Norman Emergency Medical Associates LLC | Emergency Medicine | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2011-08-15 |
| 1790073278 | 24 7 Md Pllc | Internal Medicine | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2011-07-18 |
| 1336454156 | North Carolina Em-i Medical Services PC | Physician Assistant | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2010-08-17 |
| 1215242557 | Inland Sea Inpatient Services | Internal Medicine | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2010-08-11 |
| 1477867752 | Fox Mountain Emergency Physicians | Emergency Medicine | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2010-07-29 |
| 1710143755 | Novant Medical Group, Inc. | Hospitalist | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2008-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
| 1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
| 1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
| 1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
| 1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
| 1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
| 1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
| 1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
| Find all providers in zip 28117 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1740557008 | Mooresville Ppm LLC | Pediatrics | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2011-11-30 |
| 1700028982 | Mooresville Ppm LLC | Pediatrics | 131 Medical Park Rd, Suite 302, Mooresville, NC 28117-8522 | 2009-04-02 |
| 1295750651 | Kevin C Addison | Pediatrics | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2006-07-13 |
| 1710910385 | Laura N Reniker | Pediatrics | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2006-07-08 |
| 1265470207 | Taisser Mostafa Atrak | Pediatrics | 171 Fairview Rd, Mooresville, NC 28117-9500 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396181764 | Erin Elizabeth Hayes Orth | Pediatrics | 1121 North Church Street, Greensboro, NC 27401 | 2013-05-13 |
| 1518202969 | Ronald Paul Gregoire | Pediatrics | 207 Cabbage Inlet Ln, Wilmington, NC 28409-3004 | 2012-12-11 |
| 1225396690 | Wesley Matthew Jackson | Pediatrics | 5801 Mountain Island Dr, Durham, NC 27713-8909 | 2012-04-24 |
| 1982915179 | Jennifer Lee Nash Holman | Pediatrics | Wfsm Department of Pediatrics, Medical Center Boulevard, Winston Salem, NC 27157-1081 | 2010-06-23 |
| 1306023742 | Scott Allan Witt | Pediatrics | Duke University Medical Center Department of Pediatrics, Dumc Box 3179, Durham, NC 27710-0001 | 2008-01-29 |
| 1386827335 | Piedmont Neonatology PC | Pediatrics | 628 Green Valley Road, Suite 210, Greensboro, NC 27408-7789 | 2007-12-13 |
| 1508959420 | Neonatology Services of Hickory, Pllc | Pediatrics | 352 2nd St. Nw, Suite #205, Hickory, NC 28601 | 2006-10-02 |
| 1104840248 | Roy Schneiderman | Pediatrics | 655 Lake Dornoch Drive, Pinehurst, NC 28374-7135 | 2006-07-26 |
| 1588617948 | Usha Doshi | Pediatrics | 101 Maynard Crossing Ct, N/a, Cary, NC 27513-8723 | 2006-05-18 |
| 1689634792 | Christie C. Davanzo | Pediatrics | 628 Green Valley Rd, Suite 210, Greensboro, NC 27408-7730 | 2006-03-23 |
| Find all providers with the same taxonomy | ||||
| City | MOORESVILLE |
| Zip Code | 28117 |
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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.