NOVANT MEDICAL GROUP, INC. (NPI# 1407369440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407369440 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH PEDIATRICS SYMPHONY PARK |
| Practice Address |
6010 Carnegie Blvd Charlotte NC 28209-4637 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043849966 |
| Practice Fax Number | 7043849967 |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2018-12-29 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatrics Symphony Park | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4105 Matthews Mint Hill Rd, Matthews, NC 281053633 | 7043849966 |
| 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 |
6010 CARNEGIE BLVD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28209-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386677896 | Kerry T Van Voorhis | Pediatrics | 6010 Carnegie Blvd, Charlotte, NC 28209-4637 | 2006-07-08 |
| 1194853457 | Kasey Wymer Scannell | Pediatrics | 6010 Carnegie Blvd, Charlotte, NC 28209-4637 | 2007-03-01 |
| 1992864524 | Michael J. Bean | Pediatrics | 6010 Carnegie Blvd, Charlotte, NC 28209-4637 | 2006-12-08 |
| 1265446942 | Andrew Robert Shulstad | Pediatrics | 6010 Carnegie Blvd, Charlotte, NC 28209-4637 | 2006-07-28 |
| 1265456495 | Stephanie Rozier Richter | Pediatrics | 6010 Carnegie Blvd, Charlotte, NC 28209-4637 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194382200 | Christopher Joseph Malara | Occupational Therapy Assistant | 3600 Park Rd, Charlotte, 28209, Nc, Charlotte, NC 28209 | 2019-05-23 |
| 1982187571 | Elizabeth Black Smith | Dietitian, Registered | 5821 Fairview Road, Suite 216, Charlotte, NC 28209 | 2018-09-11 |
| 1235611690 | Shearer Counseling Services Pllc | Counselor | 5200 Park Road Ste 200-3, Charlotte, NC 28209 | 2018-09-02 |
| 1942796396 | Wade Medical Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 4400 Park Rd Unit 315, Charlotte, NC 28209 | 2018-07-09 |
| 1750803672 | Stephanie Rindner | Behavior Technician | 716 Marsh Road, Charlotte, NC 28209 | 2017-07-12 |
| 1861939621 | Carolinas Healthcare System | General Acute Care Hospital | 3329 Weston St, Charlotte, NC 28209 | 2017-01-31 |
| 1275943011 | Cameron Cunningham | Anesthesiology | 1515 Mockingbird Ln Ste 680, Charlotte, NC 28209 | 2014-05-02 |
| 1013299205 | Digital Ultrasound Associates | Spec/Tech, Cardiovascular | 4450 South Blvd Suite 4, Charlotte, NC 28209 | 2011-09-13 |
| 1801117676 | Rosemary Nmi Lucas | Physical Therapist | 2910 Selwyn Ave #359, Charlotte, NC 28209 | 2010-06-16 |
| 1194049767 | Frances Massey Harley | Speech-Language Pathologist | 715 Hartford Avenue, Sedgefield Elementary School, Charlotte, NC 28209 | 2010-03-25 |
| Find all providers in zip 28209 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - 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 |
|---|---|---|---|---|
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| 1962042416 | Carolinas Physicians Network Inc | Pediatrics | 1308 Scott Ave, Charlotte, NC 28204-2918 | 2020-01-13 |
| 1083175533 | Denise Makala | Pediatrics | 1000 Blythe Blvd 4th Floor, Meb, Cmc/levine Children's Hospital, Charlotte, NC 28203-5812 | 2019-03-27 |
| 1639565526 | Emily Ogletree | Pediatrics | 8401 Medical Plaza Dr Ste 220, Charlotte, NC 28262-8700 | 2015-04-08 |
| 1811392343 | Adriana Virginia Rosado-jimenez | Pediatrics | 10340 Park Rd Ste B, Charlotte, NC 28210-8401 | 2014-10-27 |
| 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.