NOVANT MEDICAL GROUP, INC. (NPI# 1447877931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447877931 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
6331 Carmel Rd Ste 102 Charlotte NC 28226-8286 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043169022 |
| Practice Fax Number | 7043169026 |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatric Allergy & Immunology | 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 |
6331 CARMEL RD STE 102 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-8286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255375424 | Augustus G Parker IIi | Obstetrics & Gynecology | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2006-06-16 |
| 1083220339 | Ashleigh Starnes | Nurse Practitioner | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2020-09-22 |
| 1871148288 | Felicia Hunt | Nurse Practitioner | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2019-08-04 |
| 1669032231 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2019-06-17 |
| 1609346709 | Allison M Lachowitz | Dietitian, Registered | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2018-11-30 |
| 1316417959 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-11-27 |
| 1699243485 | Forsyth Medical Group, LLC | Obstetrics & Gynecology | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2018-11-09 |
| 1679050017 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-07-27 |
| 1891271482 | Novant Medical Group, Inc. | Psychiatry & Neurology | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-07-17 |
| 1861978785 | Novant Medical Group, Inc. | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8246 | 2018-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 2080P0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Allergy/Immunology |
| A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134765126 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-11-25 |
| 1669715413 | Puja Sood Rajani | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226-8286 | 2013-03-30 |
| 1033222864 | Amanda Dale-shall | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316107295 | Timothy Paul Moran | Pediatrics | 333 S Columbia St, Cb# 7231, Chapel Hill, NC 27599-0001 | 2008-06-13 |
| 1932193299 | Teresa Sue Bratton | Pediatrics | 1110 Sunset Dr, Greensboro, NC 27408-7214 | 2005-09-01 |
| 1164415477 | Allison L Freeman | Pediatrics | 3815 Ridge Crest Dr Ste 156-158, Saint James, NC 28461-9059 | 2005-08-23 |
| 1821288168 | Michelle L Hernandez | Pediatrics | 101 Manning Dr, Chapel Hill, NC 27599-0001 | 2007-08-01 |
| 1619042736 | Rebecca H. Buckley | Pediatrics | 4101 N Roxboro St, 362 Jones Building Duke University Medical Center, Durham, NC 27704-2121 | 2006-11-22 |
| 1568442242 | Bruce Kenneth Bacot | Pediatrics | 11 Vanderbilt Park Dr, Asheville, NC 28803-1700 | 2006-01-19 |
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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.