NOVANT MEDICAL GROUP, INC. (NPI# 1295226223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295226223 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH GYNECOLOGIC SURGERY & PELVIC PAIN |
| Practice Address |
6324 Fairview Rd Ste 440 Charlotte NC 28210-4278 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043841407 |
| Practice Fax Number | 7043841408 |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Gynecologic Surgery & Pelvic Pain | Doing Business As Name - Organization |
| Novant Health Pelvic Health and Surgery | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6324 Fairview Rd Ste 390, Charlotte, NC 282104173 | 7043847835 |
| 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 |
6324 FAIRVIEW RD STE 440 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-4278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558367680 | Alyse Kelly-jones | Obstetrics & Gynecology | 6324 Fairview Rd Ste 440, Charlotte, NC 28210-4278 | 2005-06-23 |
| 1326686890 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 6324 Fairview Rd Ste 440, Charlotte, NC 28210-4278 | 2019-12-16 |
| 1750609251 | Jed Ryan Schortz | Obstetrics & Gynecology | 6324 Fairview Rd Ste 440, Charlotte, NC 28210-4278 | 2010-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922645571 | Novant Medical Group, Inc. | Surgery | 6324 Fairview Rd Ste 420, Charlotte, NC 28210-3372 | 2019-12-03 |
| 1154806271 | The Cosmetic Concierge, Pllc | Surgery | 325 Arlington Ave Unit B, Charlotte, NC 28203-4574 | 2018-09-25 |
| 1619363538 | William Charles Sherrill IIi | Surgery | 1000 Blythe Blvd Ste 601, Charlotte, NC 28203-5812 | 2015-04-07 |
| 1174968069 | Jonathan Bouchez | Surgery | 1000 Blythe Bvld., Charlotte, NC 28203 | 2013-05-06 |
| 1437475779 | Blair A Wormer | Surgery | 1901 Brunswick Ave Ste 200, Charlotte, NC 28207-1897 | 2010-04-12 |
| 1407039845 | Charles Arthur Hill IIi | Surgery | 325 Hawthorne Ln Ste 100, Charlotte, NC 28204 | 2007-12-07 |
| 1841491370 | Johnnie Lyles | Surgery | 2908 Oak Lake Blvd, Suite 205, Charlotte, NC 28208-7703 | 2007-05-31 |
| 1619000486 | Gordon W Jacobs | Surgery | 14920 Wyndham Oaks Dr, Charlotte, NC 28277-1512 | 2007-03-13 |
| 1750421228 | Sandra Giller | Surgery | 1918 Randolph Rd Ste 130, Charlotte, NC 28207-1107 | 2007-02-07 |
| 1831255009 | Wendell Aubrey Goins | Surgery | 9336 Blakeney Centre Dr, Ste 100b, Charlotte, NC 28277-6666 | 2006-12-29 |
| 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.