NOVANT MEDICAL GROUP, INC (NPI# 1548737745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548737745 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Practice Address |
240 Hospital Dr Ne Bolivia NC 28422-8346 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043845416 |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2018-10-26 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Surgical Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
| 1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 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 |
240 HOSPITAL DR NE |
| City | BOLIVIA |
| State | NC |
| Zip Code | 28422-8346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790622 | Miller J Van Vliet | Anesthesiology | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2005-06-17 |
| 1679106413 | Ingrit Kolpeja | Nurse Practitioner | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2020-02-20 |
| 1689132516 | Brunswick Community Hospital, LLC | General Acute Care Hospital | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2019-03-11 |
| 1174087241 | Zachary Davis Maier | Physician Assistant | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2019-01-23 |
| 1245703065 | Leslie Ann Cobb | Nurse Practitioner | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2019-01-03 |
| 1457822264 | Brunswick Physician Partners, Pllc | Emergency Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2018-12-06 |
| 1669905972 | Alan Bloszko | Internal Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2017-04-05 |
| 1720449010 | Judith Cameron Maguire | Physician Assistant | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2016-03-14 |
| 1902274277 | Daryl Holden Turlington | Physician Assistant | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2015-09-03 |
| 1811370695 | Lisa Macdonald | Pharmacist | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2015-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616596 | Riccobene and Associates Xli, Dds, P.a. | Dentist | 211 Midway Commons, Suite 116, Bolivia, NC 28422 | 2020-10-15 |
| 1962029942 | Novant Medical Group. Inc. | Family Medicine | 150 College Rd Ne, Bolivia, NC 28422 | 2020-06-25 |
| 1033730866 | Tamika Jocinda Yushaw | Social Worker | 25 Courthouse Drive Ne, Bolivia, NC 28422 | 2020-05-04 |
| 1821648882 | Daniel Burk | Physician Assistant | 584 Hospital Drive Suite A, Bolivia, NC 28422 | 2019-09-12 |
| 1427452283 | East Carolina University School of Dental Medicine-brunswick | Dentist | 100 Brunswick Medical Center Parkway, Bolivia, NC 28422 | 2014-10-22 |
| 1689080632 | Cecilia Liu | Dentist | 3071 Southport Supply Rd Se, Bolivia, NC 28422 | 2014-07-09 |
| 1922372341 | Lorie L Harding | Physician Assistant | 584 Hospital Dr Ne Unit C, Bolivia, NC 28422 | 2012-03-02 |
| 1902095383 | Cayce Mccall Patterson | Physical Therapist | 35 Referendum Dr, Brunswick County Schools, Bolivia, NC 28422 | 2007-10-22 |
| 1235288622 | Susan Beth Kam | Psychologist | 63 Stamp Act Drive, Bolivia, NC 28422 | 2007-01-09 |
| 1578632477 | Sarah E Oxford | Case Manager/Care Coordinator | 63 Stamp Act Dr, Building M, Bolivia, NC 28422 | 2006-11-06 |
| Find all providers in zip 28422 | ||||
| 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 |
|---|---|---|---|---|
| 1669905972 | Alan Bloszko | Internal Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2017-04-05 |
| 1780812867 | Lawrence J Mason | Internal Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2009-06-26 |
| 1649311457 | William Joseph Faircloth | Internal Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2007-02-12 |
| 1811975469 | David J Koenig | Internal Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2006-01-04 |
| 1982682712 | James Bruce Adams | Internal Medicine | 240 Hospital Dr Ne, Bolivia, NC 28422-8346 | 2006-01-03 |
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| 1104431725 | Progress Medical, Pllc | Internal Medicine | 2104 Talmage Dr, Leland, NC 28451-9340 | 2020-09-10 |
| 1568076222 | Raleigh Holistic Healthcare | Internal Medicine | 875 Walnut St Ste 275-9, Cary, NC 27511-4215 | 2020-09-01 |
| 1346852407 | Wake Specialty Physicians | Internal Medicine | 2001 S Main St Ste 200, Wake Forest, NC 27587-1652 | 2020-08-20 |
| 1811508591 | Guha Medical, Pa | Internal Medicine | 111 W Lewis St, Greensboro, NC 27406-1343 | 2020-08-14 |
| 1053921874 | Wake Specialty Phisicians, LLC | Internal Medicine | 601 Oberlin Rd, Raleigh, NC 27605-1126 | 2020-08-06 |
| 1417566779 | Old Town M.d. | Internal Medicine | 500 Westover Dr Ste 10417, Sanford, NC 27330-8941 | 2020-07-23 |
| 1174141683 | Telepartners for Integrated Health | Internal Medicine | 9413 Tillot Dr, Matthews, NC 28105-1567 | 2020-07-10 |
| 1821613480 | Carolinas Physicians Network Inc | Internal Medicine | 8815 Christenbury Pkwy Ste 30, Concord, NC 28027-0261 | 2020-06-10 |
| 1932722980 | Carolinas Physicians Network Inc | Internal Medicine | 2041 South Blvd, Ste 100, Charlotte, NC 28203-5062 | 2020-05-26 |
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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.