NOVANT MEDICAL GROUP, INC (NPI# 1588610471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588610471 |
Entity Type | Organization |
Organization Name | NOVANT MEDICAL GROUP, INC |
Other Organization Name | NOVANT HEALTH PSYCHIATRIC ASSOCIATES |
Practice Address |
1900 Randolph Road Suite 800 Charlotte NC 28207-1110 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 7043841246 |
Practice Fax Number | 7043846072 |
Mailing Telephone | 7043841246 |
Mailing Fax Number | 7043846072 |
Enumeration Date | 2006-05-25 |
Last Update Date | 2013-07-05 |
Authorized Official Name | MR. GEOFFREY K GARDNER (VP OF FINANCE) |
Authorized Official Telephone | 7043841246 |
Is Organization Subpart | Y |
Parent Organization Name | NOVANT MEDICAL GROUP, INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BCBS NC | 015Y5 | 01 |
NC | 6006145 (LCSWS ONLY) | 05 | |
NC | RAILROAD MEDICARE | CC5118 | 01 |
NC | 89015Y5 | 05 | |
SC | NPB139 | 05 |
Other Name | Type Code |
---|---|
Novant Health Psychiatric Associates | 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 |
1900 RANDOLPH ROAD SUITE 800 |
City | CHARLOTTE |
State | NC |
Zip Code | 28207-1110 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619932746 | Joanna E York | Emergency Medicine | 1900 Randolph Road, Suite 900, Charlotte, NC 28207-1117 | 2006-04-20 |
1790910479 | Viranga Chamindi Pathiraja | Psychiatry & Neurology | 1900 Randolph Road, Suite 800, Charlotte, NC 28207-1110 | 2009-05-25 |
1962657353 | Novant Medical Group, Inc. | Psychiatry & Neurology | 1900 Randolph Road, Suite 300, Charlotte, NC 28207-1106 | 2008-11-26 |
1922182492 | Andrew Schulman | Surgery | 1900 Randolph Road, Ste 210, Charlotte, NC 28207-1106 | 2006-10-24 |
1366409492 | Novant Medical Group, Inc | Pediatrics | 1900 Randolph Road, Suite 1010, Charlotte, NC 28207-1117 | 2006-05-01 |
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 | 2084P0800X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Psychiatry |
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417464900 | St Lazarus Behavioral Health PC | Psychiatry & Neurology | 8401 Medical Plaza Dr Ste 355, Charlotte, NC 28262-9718 | 2018-01-05 |
1942666334 | Daymark Recovery Services Inc | Psychiatry & Neurology | 127 N Tryon St Unit 516, Charlotte, NC 28202-2194 | 2016-01-14 |
1275827990 | Erica Elise Herman | Psychiatry & Neurology | 6060 Piedmont Row Dr S Ste 500, Charlotte, NC 28287-3803 | 2011-05-31 |
1710162078 | Patterson Healthcare Pa | Psychiatry & Neurology | 6115 Park South Drive, Suite 130, Charlotte, NC 28210-3269 | 2008-01-07 |
1871786830 | Wallace Harden Smith II | Psychiatry & Neurology | 3120 Cambridge Rd, Charlotte, NC 28209-1304 | 2007-08-23 |
1639386014 | Odette Cianchini Valder | Psychiatry & Neurology | 413 S Sharon Amity Rd, Suite B, Charlotte, NC 28211-2865 | 2007-05-16 |
1265659965 | Malti Praful Mehta | Psychiatry & Neurology | 459 N Wendover Rd, Malti and P Mehta Pa, Charlotte, NC 28211 | 2007-04-20 |
1497877468 | Mary Mcmahan Christenbury | Psychiatry & Neurology | 2231 Thornridge Rd, Charlotte, NC 28226-6446 | 2007-04-03 |
1447374459 | Susan K Gillette | Psychiatry & Neurology | 3604 Hampton Manor Dr, Charlotte, NC 28226-7006 | 2007-03-16 |
1851445209 | Preetinder Paul Singh Brar | Psychiatry & Neurology | 8029 Corporate Center Dr Ste 200, Charlotte, NC 28226-4548 | 2007-01-23 |
Find all providers in CHARLOTTE |
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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.