NOVANT MEDICAL GROUP, INC (NPI# 1386164051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386164051 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH PEDIATRIC ENDOCRINOLOGY |
| Practice Address |
201 Queens Rd Charlotte NC 28204-3217 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165285 |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | GEOFFREY GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043162335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatric Endocrinology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 330 Billingsley Rd Ste 101, Charlotte, NC 282115020 | 7043162335 | 7043162326 |
| 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 |
201 QUEENS RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083663454 | Larry Jason Byrd | Nurse Practitioner | 201 Queens Rd, Charlotte, NC 28204-3217 | 2006-05-10 |
| 1134765126 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-11-25 |
| 1093376642 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-06-25 |
| 1568027001 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-05-09 |
| 1417433947 | Shelly Spoerre | Dietitian, Registered | 201 Queens Rd, Charlotte, NC 28204-3217 | 2018-07-18 |
| 1205320306 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204 | 2018-06-21 |
| 1639695133 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204 | 2017-08-16 |
| 1417477977 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-26 |
| 1386173581 | Jonathan Mercer Foell | Specialist/Technologist | 201 Queens Rd, Charlotte, NC 28204 | 2017-06-09 |
| 1295278471 | Christina Simpson | Nurse Practitioner | 201 Queens Rd, Charlotte, NC 28204-3217 | 2016-11-21 |
| 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 | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| 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 |
|---|---|---|---|---|
| 1801825914 | Lisa Houchin | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-07-01 |
| 1700213113 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 101 E Wt Harris Blvd, Bldg 3000 Ste 3301c, Charlotte, NC 28262-3485 | 2013-09-30 |
| 1962778266 | Diana Elizabeth Miller | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2012-03-30 |
| 1962797654 | Carolinas Medical Center-northeast | Pediatrics | 101 E W T Harris Blvd, Bldg 3000, Suite 3301c, Charlotte, NC 28262-7000 | 2011-06-10 |
| 1053605873 | Elizabeth Dabrowski | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2011-06-09 |
| 1184811937 | Jakub Mieszczak | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2007-09-26 |
| 1679582134 | Pediatric Endocrinology & Diabetes Specialists | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-08-05 |
| 1740212901 | Mark Vanderwel | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-07-07 |
| 1609806264 | Malaka Baharah Jackson | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2006-07-03 |
| 1912937475 | Mark Parker | Pediatrics | 4501 Cameron Valley Pkwy, Suite 200, Charlotte, NC 28211-4297 | 2006-07-03 |
| 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.