NOVANT MEDICAL GROUP INC (NPI# 1538400890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538400890 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH PROVIDENCE OB/GYN |
| Practice Address |
1718 E 4th St Suite 907 Charlotte NC 28204-3261 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043724000 |
| Practice Fax Number | 7043344855 |
| Mailing Telephone | 7043724000 |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | GEOFFERY K GARDNER (V P FINANCE) |
| Authorized Official Telephone | 7043849094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Providence OB/GYN | 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 |
1718 E 4TH ST SUITE 907 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841298239 | Kevin Hsu | Internal Medicine | 1718 E 4th St, Ste 501, Charlotte, NC 28204-3260 | 2005-07-11 |
| 1205373081 | Miranda L Williams | Physician Assistant | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2017-01-31 |
| 1881138873 | Shannon Scandone | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-12-09 |
| 1063963866 | Jessica Puskarich | Nurse Practitioner | 1718 E 4th St, Suite 307, Charlotte, NC 28204-3261 | 2016-10-18 |
| 1801343793 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 601, Charlotte, NC 28204-3261 | 2016-09-08 |
| 1497107536 | Kelly J Coleman | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-07-12 |
| 1447616602 | Lindsay Spears Taylor | Physician Assistant | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-01-04 |
| 1982089322 | Melanie Moshier | Genetic Counselor, MS | 1718 E 4th St, Suite 608, Charlotte, NC 28204-3261 | 2015-07-28 |
| 1962886218 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 401, Charlotte, NC 28204-3261 | 2015-07-16 |
| 1780071373 | Shannon Deluca | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2015-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| 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 |
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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.