NOVANT MEDICAL GROUP INC (NPI# 1508107863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508107863 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH SLEEP CENTER |
| Practice Address |
1900 Randolph Rd Suite 300 Charlotte NC 28207-1106 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043846225 |
| Mailing Telephone | 7043846225 |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-07-31 |
| Authorized Official Name | MR. GEOFFREY KEITH GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043847603 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2080S0012X |
Pediatrics Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Sleep Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1205355799 | Novant Medical Group Inc | Family Medicine | 16525 Holly Crest Ln Ste 250, Huntersville, NC 28078-4912 | 2017-09-15 |
| 1679090468 | Novant Medical Group Inc | Internal Medicine | 12311 Copper Way Ste 100, Charlotte, NC 28277-3643 | 2017-08-23 |
| 1003332016 | Novant Medical Group Inc | Internal Medicine | 10030 Gilead Rd Ste 344, Huntersville, NC 28078-7545 | 2017-08-22 |
| 1255709432 | Novant Medical Group Inc | Family Medicine | 19485 Old Jetton Road, Suite 100, Cornelius, NC 28031-6583 | 2015-09-04 |
| 1215326665 | Novant Medical Group Inc | Surgery | 819 N Atlantic Ave, Southport, NC 28461-3531 | 2015-01-22 |
| 1194113662 | Novant Medical Group Inc | Obstetrics & Gynecology | 1730 Kernersville Medical Parkway, Suite 104, Kernersville, NC 27284-7198 | 2015-01-06 |
| 1437556594 | Novant Medical Group Inc | Internal Medicine | 13 Medical Campus, Suite 102, Supply, NC 28462-4093 | 2014-12-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Novant Medical Group Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Novant Medical Group Inc. | 2085 Frontis Plaza Blvd, Winston Salem, North Carolina 27103 |
| Street Address |
1900 RANDOLPH RD SUITE 300 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881689362 | Barbara Elizabeth Kissam | Pediatrics | 1900 Randolph Rd, Suite 1010, Charlotte, NC 28207-1122 | 2005-09-12 |
| 1144769332 | Courtney Wiseman | Physician Assistant | 1900 Randolph Rd, Suite 800, Charlotte, NC 28207-1122 | 2017-02-21 |
| 1700339785 | Yu Wei Shan | Nurse Practitioner | 1900 Randolph Rd, Suite 800, Charlotte, NC 28207-1122 | 2016-07-26 |
| 1891182127 | Novant Medical Group,inc | Pediatrics | 1900 Randolph Rd, Suite 300, Charlotte, NC 28207-1122 | 2015-04-24 |
| 1578979936 | Kristen Elizabeth Bush | Physician Assistant | 1900 Randolph Rd, Ste 900, Charlotte, NC 28207-1122 | 2014-07-07 |
| 1003235524 | Novant Medical Group Inc | Internal Medicine | 1900 Randolph Rd, Suite 216, Charlotte, NC 28207-1122 | 2014-04-11 |
| 1639422264 | Anthony James Mignanelli II | Nurse Practitioner | 1900 Randolph Rd, Suite 900, Charlotte, NC 28207-1122 | 2012-10-19 |
| 1851642169 | Meagan Marie Bullock | Social Worker | 1900 Randolph Rd, Suite 800, Charlotte, NC 28207-1122 | 2012-09-26 |
| 1114299294 | Worley Shaun Lynch | Physician Assistant | 1900 Randolph Rd, Suite 900, Charlotte, NC 28207-1122 | 2012-02-03 |
| 1124335427 | Ppg Pathology and Diagnostics Pllc | Clinical Medical Laboratory | 1900 Randolph Rd, Suite 708, Charlotte, NC 28207-1122 | 2010-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 207RS0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sleep Medicine |
| An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205177045 | Novant Medical Group Inc | Internal Medicine | 11840 Southmore Dr Ste 201, Charlotte, NC 28277-0785 | 2013-03-04 |
| 1861455651 | Jeannine Louise Gingras | Internal Medicine | 6207 Park South Dr, Suite 101, Charlotte, NC 28210-3267 | 2006-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508499286 | Nations Sleep Disorders Center of North Carolina LLC | Internal Medicine | 658 N Spence Ave, Goldsboro, NC 27534-4233 | 2020-02-20 |
| 1437782109 | Nations Sleep Disorders Center of The Carolinas LLC | Internal Medicine | 715 Gum Branch Rd Ste 8, Jacksonville, NC 28540-6427 | 2020-02-20 |
| 1235414830 | Cleveland Health Ventures LLC | Internal Medicine | 823 E. King Street, Kings Mountain, NC 28086-3186 | 2011-10-14 |
| 1861795916 | Cleveland Health Ventures LLC | Internal Medicine | 802 N Lafayette St, Shelby, NC 28150-3831 | 2010-12-13 |
| 1043545056 | Mid Atlantic Neurology & Sleep Medicine, P.a. | Internal Medicine | 34 Office Park Dr Ste 100, Jacksonville, NC 28546-3221 | 2009-10-08 |
| 1205080314 | Lafayette Sleep Lab Pulmonology | Internal Medicine | 1746 Metromedical Dr, Fayetteville, NC 28304-3861 | 2008-11-17 |
| 1306061551 | Benjamin P Graef | Internal Medicine | 212 Le Phillip Ct Ne, Suite 105, Concord, NC 28025-2984 | 2007-04-14 |
| 1700958238 | Carolina Pulmonary and Comprehensive Sleep Center | Internal Medicine | 1198 Wyke Rd, Shelby, NC 28150-4259 | 2006-11-13 |
| 1508876418 | Glenn W Burris | Internal Medicine | 270 Pine Mountain Road, Suite 1, Hudson, NC 28638 | 2006-08-09 |
| 1154375202 | Wilson Sleep Disorders Center, Pa | Internal Medicine | 110 Brentwood Center Ln N, Wilson, NC 27896-1710 | 2006-05-22 |
| Find all providers with the same taxonomy | ||||
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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.