NOVANT MEDICAL GROUP INC (NPI# 1548410996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548410996 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH FAMILY & INTERNAL MEDICINE SOUTH BRUNSWICK |
| Practice Address |
75 Emerson Bay Street Sw Suite 102 Carolina Shores NC 28467-2498 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9105798363 |
| Practice Fax Number | 9105798306 |
| Mailing Telephone | 9105798363 |
| Mailing Fax Number | 9105798306 |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2016-08-08 |
| Authorized Official Name | GEOFFREY K. GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043849672 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5950530 | 05 | |
| NC | RAILROAD MEDICARE | CC5118 | 01 |
| Other Name | Type Code |
|---|---|
| Novant Health Family & Internal Medicine South Brunswick | 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 |
75 EMERSON BAY STREET SW SUITE 102 |
| City | CAROLINA SHORES |
| State | NC |
| Zip Code | 28467-2498 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578052098 | Felicia Lavern Gore | Adult Companion | 330 Treeacres Circle Nw, Calabash, NC 28467 | 2018-05-10 |
| 1063914000 | Connor David Price | Occupational Therapist | 9600 Number 5 School Road Northwest, Calabash, NC 28467 | 2018-03-06 |
| 1508115569 | Edward Ragland Thomas Iv | Pharmacist | 10227 Beach Drive Sw, Calabash, NC 28467 | 2012-09-06 |
| 1194941286 | Calabash Family Pharmacy Inc | Pharmacy | 10080 Beach Drive Sw, Calabash, NC 28467 | 2007-04-17 |
| 1639210529 | Forever Yours, Inc | Durable Medical Equipment & Medical Supplies | 262 Koolabrew Drive, Calabash, NC 28467 | 2007-02-12 |
| 1629123807 | Thomas Drugs Inc | Durable Medical Equipment & Medical Supplies | 10227 Beach Drive, Calabash, NC 28467 | 2007-01-25 |
| 1417027046 | Pamela C Neves | Counselor | Old Georgetown Centre Hwy 179, Suite 9, Calabash, NC 28467 | 2006-11-09 |
| 1164533493 | David Philip Deeb | Dentist | 10271 Beach Dr Sw, Calabash, NC 28467 | 2006-08-31 |
| 1144331471 | Deeb & Fanning Dds Pa | Dentist | 10271 Beach Drive Sw, Calabash, NC 28467 | 2006-08-31 |
| 1588770002 | Ted Hadley Sanders | Dentist | 9220-1 Beach Dr Sw, Calabash, NC 28467 | 2006-08-21 |
| Find all providers in zip 28467 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679508386 | Maria Rivell | Internal Medicine | 75 Emerson Bay Rd Ste 102, Carolina Shores, NC 28467 | 2006-07-11 |
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| 1417566779 | Old Town M.d. | Internal Medicine | 500 Westover Dr Ste 10417, Sanford, NC 27330-8941 | 2020-07-23 |
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| Find all providers with the same taxonomy | ||||
| City | CAROLINA SHORES |
| Zip Code | 28467 |
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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.