NOVANT MEDICAL GROUP INC (NPI# 1518206374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518206374 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH VASCULAR DIAGNOSTICS |
| Practice Address |
1710 Kernersville Medical Pkwy Suite 202 Kernersville NC 27284-7155 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3367685445 |
| Practice Fax Number | 3367687950 |
| Mailing Telephone | 3367685445 |
| Mailing Fax Number | 3367687950 |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2015-03-18 |
| Authorized Official Name | GEOFFREY K. GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Vascular Diagnostics | 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 |
1710 KERNERSVILLE MEDICAL PKWY SUITE 202 |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-7155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780615799 | James Dasher | Surgery | 1710 Kernersville Medical Pkwy, Suite 220, Kernersville, NC 27284-7155 | 2006-07-06 |
| 1851843825 | Rayne Salyers | Dietitian, Registered | 1710 Kernersville Medical Pkwy, Suite 101, Kernersville, NC 27284-7155 | 2016-10-26 |
| 1659821056 | Shanon Armfield | Dietitian, Registered | 1710 Kernersville Medical Pkwy, Suite 210, Kernersville, NC 27284-7155 | 2016-10-10 |
| 1548627052 | Rebecca Jones | Dietitian, Registered | 1710 Kernersville Medical Pkwy, Suite 101, Kernersville, NC 27284-7155 | 2016-01-28 |
| 1295113926 | Amanda Smith | Dietitian, Registered | 1710 Kernersville Medical Pkwy, Suite 210, Kernersville, NC 27284-7155 | 2015-05-14 |
| 1578972881 | Novant Medical Group Inc | Internal Medicine | 1710 Kernersville Medical Pkwy, Suite 220, Kernersville, NC 27284-7155 | 2014-08-12 |
| 1013347574 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1710 Kernersville Medical Pkwy, Suite 116, Kernersville, NC 27284-7155 | 2013-11-20 |
| 1730522749 | Joyce Prevatt Eury | Dietitian, Registered | 1710 Kernersville Medical Pkwy, Suite 210, Kernersville, NC 27284-7155 | 2013-04-09 |
| 1699015784 | Novant Medical Group Inc | Surgery | 1710 Kernersville Medical Pkwy, Suite 202, Kernersville, NC 27284-7146 | 2013-02-26 |
| 1427397504 | Novant Medical Group, Inc. | Surgery | 1710 Kernersville Medical Pkwy, Suite 202, Kernersville, NC 27284-7146 | 2013-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699015784 | Novant Medical Group Inc | Surgery | 1710 Kernersville Medical Pkwy, Suite 202, Kernersville, NC 27284-7146 | 2013-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831717693 | Mcleod Physician Associates II | Surgery | 690 Sunset Blvd N Ste 208, Sunset Beach, NC 28468-5332 | 2020-07-08 |
| 1053785220 | Novant Medical Group, Inc. | Surgery | 1420 Us Highway North 52, Suite B, Albermarle, NC 28001 | 2015-11-25 |
| 1962756148 | Vein Essentials, PC | Surgery | 580 Mccarthy Blvd, New Bern, NC 28562-5217 | 2012-11-09 |
| 1548544984 | Statesville Hma Medical Group, LLC | Surgery | 1703 Davie Ave, Statesville, NC 28677-3521 | 2011-10-04 |
| 1639310642 | Vcp Raleigh, LLC | Surgery | 6905 Knightdale Blvd Ste 105, Knightdale, NC 27545-6504 | 2009-03-20 |
| 1104001742 | Raleigh Vein & Laser Center Pa | Surgery | 10000 Falls of Neuse Rd., Suite 303, Raleigh, NC 27614 | 2008-01-02 |
| 1265613624 | Pinehurst Surgical Clinic Pa | Surgery | 1705b Berwick Dr, Laurinburg, NC 28352-5523 | 2007-11-14 |
| 1871791301 | Kathryn Lorann Davis | Surgery | 2001 Vail Ave Ste 320, Charlotte, NC 28207-1222 | 2007-07-05 |
| 1578656773 | Coastal Carolina Surgical Associates, P.a. | Surgery | 1411 Physicians Drive, Wilmington, NC 28401-7338 | 2006-10-02 |
| 1750499851 | Michael David Lininger | Surgery | 149 Macarthur St, Asheboro, NC 27203-5410 | 2006-08-28 |
| Find all providers with the same taxonomy | ||||
| City | KERNERSVILLE |
| Zip Code | 27284 |
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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.