NOVANT MEDICAL GROUP, INC. (NPI# 1447414925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447414925 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH UROGYNECOLOGY |
| Practice Address |
6324 Fairview Rd Ste 390 Charlotte NC 28210-4173 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043161120 |
| Practice Fax Number | 7043161121 |
| Mailing Telephone | 7043161120 |
| Mailing Fax Number | 7043161121 |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2019-10-15 |
| Authorized Official Name | GEOFFREY GARDNER (VP OPERATIONS) |
| Authorized Official Telephone | 7043161120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1447414925 | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Urogynecology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 106 Langtree Village Dr Ste 200, Mooresville, NC 281177594 | 7043847101 | 7043847102 |
| 10220 Prosperity Park Dr Ste 300, Charlotte, NC 282691106 | 7043161120 | 7043161121 |
| 8201 Healthcare Loop Ste 302, Charlotte, NC 282157072 | 7043161120 | 7043161121 |
| 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 390 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-4173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750380549 | William E Porter | Obstetrics & Gynecology | 6324 Fairview Rd, Suite 390, Charlotte, NC 28210-3271 | 2005-07-14 |
| 1184163859 | Cary Probst | Physician Assistant | 6324 Fairview Rd, Suite 390, Charlotte, NC 28210-3271 | 2017-02-15 |
| 1457710436 | Novant Medical Group Inc | Psychiatry & Neurology | 6324 Fairview Rd, Suite 350, Charlotte, NC 28210-3271 | 2016-02-18 |
| 1174991871 | Novant Medical Group, Inc | Obstetrics & Gynecology | 6324 Fairview Rd, Suite 390, Charlotte, NC 28210-3271 | 2015-09-11 |
| 1093101222 | Sashalee Stewart | Psychiatry & Neurology | 6324 Fairview Rd, Charlotte, NC 28210-3271 | 2015-04-14 |
| 1801287610 | Amy Petticrew | Physician Assistant | 6324 Fairview Rd, Suite 201, Charlotte, NC 28210-3271 | 2015-02-16 |
| 1790110484 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 6324 Fairview Rd, Charlotte, NC 28210-3271 | 2013-09-12 |
| 1023458767 | Amy Smith Medlin | Social Worker | 6324 Fairview Rd, Suite 350, Charlotte, NC 28210-3271 | 2013-06-26 |
| 1710322367 | Daniel Scott Donner | Pediatrics | 6324 Fairview Rd, Suite 350, Charlotte, NC 28210-3271 | 2013-05-08 |
| 1467644021 | Genevieve Noel Brauning | Family Medicine | 6324 Fairview Rd, Suite 201, Charlotte, NC 28210-4278 | 2007-08-16 |
| Find all providers in the same location | ||||
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649899782 | Atrium Health North Market Network LLC | Obstetrics & Gynecology | 101 E Wt Harris Blvd Ste 5002, Charlotte, NC 28262-3588 | 2020-04-09 |
| 1528617362 | Arboretum Obstetrics & Gynecology | Obstetrics & Gynecology | 3125 Springbank Ln Ste B, Charlotte, NC 28226-3379 | 2019-09-04 |
| 1548624992 | Cassandra Yoder | Obstetrics & Gynecology | 1350 S. Kings Dr., Myers Park Clinic Ob/gyn, Charlotte, NC 28207 | 2016-04-12 |
| 1043690480 | Elizabeth Lindsay Montague-farwell | Obstetrics & Gynecology | 416 E 36th St Su 200, Charlotte, NC 28205 | 2015-06-01 |
| 1285048181 | Katie Mellington Vemireddy | Obstetrics & Gynecology | 8201 Healthcare Loop Ste 302, Charlotte, NC 28215-7072 | 2014-06-18 |
| 1467899948 | Chancy Lucas | Obstetrics & Gynecology | 325 Hawthorne Ln Ste 200, Charlotte, NC 28204 | 2013-05-24 |
| 1750727293 | Stephanie Barbadora-froelich | Obstetrics & Gynecology | 416 E 36th St Ste 200, Charlotte, NC 28205 | 2013-05-10 |
| 1992076509 | Novant Medical Group, Inc | Obstetrics & Gynecology | 11030 Golf Links Dr N, Suite 100, Charlotte, NC 28277-8200 | 2012-01-13 |
| 1073898805 | Novant Medical Group Inc | Obstetrics & Gynecology | 2610 West Arrowood Road, Charlotte, NC 28273-6134 | 2011-10-12 |
| 1164714788 | Patricia Jane Mattingly | Obstetrics & Gynecology | 6324 Fairview Rd Ste 390, Charlotte, NC 28210-4173 | 2011-05-16 |
| 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.