NOVANT MEDICAL GROUP, INC. (NPI# 1295390086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295390086 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH CHARLOTTE COLON & RECTAL SURGERY |
| Practice Address |
14330 Oakhill Park Ln Ste 140 Huntersville NC 28078-3480 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043163492 |
| Practice Fax Number | 7043162637 |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | SHALA DAVIS (RCS MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Charlotte Colon & Rectal Surgery | 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 |
14330 OAKHILL PARK LN STE 140 |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-3480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487074944 | Laura Heidelberg | Surgery | 14330 Oakhill Park Ln Ste 140, Huntersville, NC 28078-3480 | 2014-04-23 |
| 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 | 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 |
|---|---|---|---|---|
| 1487074944 | Laura Heidelberg | Surgery | 14330 Oakhill Park Ln Ste 140, Huntersville, NC 28078-3480 | 2014-04-23 |
| 1336316751 | Lori Filichia Gentile | Surgery | 9735 Kincey Ave Ste 205, Huntersville, NC 28078-9120 | 2008-05-14 |
| 1497961155 | Martin J Carignan | Surgery | 14330 Oakhill Park Ln Ste 125, Huntersville, NC 28078-3481 | 2007-05-16 |
| 1578682993 | Daniel James Krochmal | Surgery | 11208 Statesville Rd, Ste 300, Huntersville, NC 28078-7635 | 2007-03-28 |
| 1730145947 | David Langdon Walrath | Surgery | 10215 Hickorywood Hill Ave, Suite B, Huntersville, NC 28078-3307 | 2006-04-25 |
| 1912983693 | Rohit Ike Bhasin | Surgery | 10030 Gilead Rd., Ste. 300, Surgical Specialists of Charlotte, P.a., Huntersville, NC 28078 | 2005-12-15 |
| 1679187173 | Novant Medical Group, Inc. | Surgery | 9735 Kincey Ave Ste 205, Huntersville, NC 28078-9120 | 2020-09-02 |
| 1205493251 | Novant Medical Group, Inc | Surgery | 10030 Gilead Rd, Huntersville, NC 28078-7545 | 2019-05-24 |
| 1265956502 | Novant Medical Group, Inc | Surgery | 9735 Kincey Ave Ste 205, Huntersville, NC 28078-9120 | 2017-07-28 |
| 1720131048 | Aaron Eli Bergsman | Surgery | 10030 Gilead Rd, Ste. 300, Huntersville, NC 28078-7545 | 2007-01-19 |
| 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.