NOVANT MEDICAL GROUP, INC (NPI# 1295974301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295974301 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | CREEKSIDE PSYCHIATRIC SERVICES AND COUNSELING |
| Practice Address |
1718 E 4th St Suite 902 Charlotte NC 28204-3261 |
| Mailing Address |
1412 Fern Creek Drive Statesville NC 28625-0000 |
| Practice Telephone | 7043847605 |
| Practice Fax Number | 7044171178 |
| Mailing Telephone | 7043847605 |
| Mailing Fax Number | 7044171178 |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |
| Authorized Official Name | DINESH PAI (VP OF OPERATIONS) |
| Authorized Official Telephone | 7043849104 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Creekside Psychiatric Services and Counseling | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
| 1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 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 |
1718 E 4TH ST SUITE 902 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841298239 | Kevin Hsu | Internal Medicine | 1718 E 4th St, Ste 501, Charlotte, NC 28204-3260 | 2005-07-11 |
| 1205373081 | Miranda L Williams | Physician Assistant | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2017-01-31 |
| 1881138873 | Shannon Scandone | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-12-09 |
| 1063963866 | Jessica Puskarich | Nurse Practitioner | 1718 E 4th St, Suite 307, Charlotte, NC 28204-3261 | 2016-10-18 |
| 1801343793 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 601, Charlotte, NC 28204-3261 | 2016-09-08 |
| 1497107536 | Kelly J Coleman | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-07-12 |
| 1447616602 | Lindsay Spears Taylor | Physician Assistant | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-01-04 |
| 1982089322 | Melanie Moshier | Genetic Counselor, MS | 1718 E 4th St, Suite 608, Charlotte, NC 28204-3261 | 2015-07-28 |
| 1962886218 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 401, Charlotte, NC 28204-3261 | 2015-07-16 |
| 1780071373 | Shannon Deluca | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2015-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417464900 | St Lazarus Behavioral Health PC | Psychiatry & Neurology | 8401 Medical Plaza Dr Ste 355, Charlotte, NC 28262-9718 | 2018-01-05 |
| 1942666334 | Daymark Recovery Services Inc | Psychiatry & Neurology | 127 N Tryon St Unit 516, Charlotte, NC 28202-2194 | 2016-01-14 |
| 1275827990 | Erica Elise Herman | Psychiatry & Neurology | 6060 Piedmont Row Dr S Ste 500, Charlotte, NC 28287-3803 | 2011-05-31 |
| 1710162078 | Patterson Healthcare Pa | Psychiatry & Neurology | 6115 Park South Drive, Suite 130, Charlotte, NC 28210-3269 | 2008-01-07 |
| 1871786830 | Wallace Harden Smith II | Psychiatry & Neurology | 3120 Cambridge Rd, Charlotte, NC 28209-1304 | 2007-08-23 |
| 1639386014 | Odette Cianchini Valder | Psychiatry & Neurology | 413 S Sharon Amity Rd, Suite B, Charlotte, NC 28211-2865 | 2007-05-16 |
| 1265659965 | Malti Praful Mehta | Psychiatry & Neurology | 459 N Wendover Rd, Malti and P Mehta Pa, Charlotte, NC 28211 | 2007-04-20 |
| 1497877468 | Mary Mcmahan Christenbury | Psychiatry & Neurology | 2231 Thornridge Rd, Charlotte, NC 28226-6446 | 2007-04-03 |
| 1447374459 | Susan K Gillette | Psychiatry & Neurology | 3604 Hampton Manor Dr, Charlotte, NC 28226-7006 | 2007-03-16 |
| 1851445209 | Preetinder Paul Singh Brar | Psychiatry & Neurology | 8029 Corporate Center Dr Ste 200, Charlotte, NC 28226-4548 | 2007-01-23 |
| 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.