NOVANT MEDICAL GROUP, INC. (NPI# 1609427335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609427335 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
6555 Kee Ln Ste 200 Harrisburg NC 28075-7463 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043162319 |
| Practice Fax Number | 7043162321 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| 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 Mint Hill OB/GYN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033723531 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy Ste 320, Matthews, NC 28105-2389 | 2020-09-02 |
| 1346868155 | Novant Medical Group, Inc. | Family Medicine | 106 Corporate Park Dr Ste 200, Mooresville, NC 28117-7134 | 2020-07-08 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1932725124 | Novant Medical Group, Inc. | Internal Medicine | 125 Queens Rd Ste 510, Charlotte, NC 28204-3215 | 2020-06-23 |
| 1922645571 | Novant Medical Group, Inc. | Surgery | 6324 Fairview Rd Ste 420, Charlotte, NC 28210-3372 | 2019-12-03 |
| 1437706256 | Novant Medical Group, Inc. | Physical Therapist | 11202 Harris Rd, Huntersville, NC 28078-7633 | 2019-08-26 |
| 1336795137 | Novant Medical Group, Inc. | Surgery | 3515 W Market St Ste 310, Greensboro, NC 27403-4438 | 2019-08-16 |
| 1104472125 | Novant Medical Group, Inc. | Neurological Surgery | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-15 |
| 1649824954 | Novant Medical Group, Inc. | Family Medicine | 6555 Kee Lane, Harrisburg, NC 28075-7463 | 2019-07-25 |
| 1285287185 | Novant Medical Group, Inc. | Lactation Consultant, Non-RN | 6324 Fairview Rd Ste 435, Charlotte, NC 28210-4278 | 2019-07-19 |
| 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 |
6555 KEE LN STE 200 |
| City | HARRISBURG |
| State | NC |
| Zip Code | 28075-7463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023080066 | Carol J Soucie | Pediatrics | 6555 Kee Ln Ste 200, Harrisburg, NC 28075-7463 | 2006-02-03 |
| 1558828194 | Novant Medical Group, Inc. | Pediatrics | 6555 Kee Ln Ste 200, Harrisburg, NC 28075-7463 | 2019-03-01 |
| 1326442062 | Christopher Upchurch | Nurse Practitioner | 6555 Kee Ln Ste 200, Harrisburg, NC 28075-7463 | 2014-10-09 |
| 1508032194 | Colleen Rochelle Black | Pediatrics | 6555 Kee Ln Ste 200, Harrisburg, NC 28075-7463 | 2008-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316576283 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 3800 Highway 49 South, Harrisburg, NC 28075 | 2020-04-03 |
| 1043726250 | Megan M. Raynor, Dmd, Pllc | Clinic/Center | 5500 Highway 49 South, Suite 100, Harrisburg, NC 28075 | 2017-12-26 |
| 1760994008 | Publix North Carolina Lp | Durable Medical Equipment & Medical Supplies | 4055 Harris Square Dr, Harrisburg, NC 28075 | 2017-10-26 |
| 1578085783 | Trey Wyate Miller | Dentist | 4291 School House Commons, Harrisburg, NC 28075 | 2017-07-10 |
| 1700320850 | R. Barrows & Associates II PC | Dentist | 7230 Caldwell Road, Harrisburg, NC 28075 | 2016-12-08 |
| 1699125393 | Megan Morse Raynor | Dentist | 5500 Hwy 49 South, Suite 100, Harrisburg, NC 28075 | 2016-06-14 |
| 1740642289 | Bradley William Lind | Podiatrist | 3800 Hwy 49 South, Harrisburg, NC 28075 | 2016-03-23 |
| 1578870630 | David A Hysell | Physical Therapist | 8555 Magnolia Springs Dr, Harrisburg, NC 28075 | 2010-09-09 |
| 1124248331 | Harrisburg Pharmacy Services Inc | Pharmacy | 4310 Physicians Blvd, Harrisburg, NC 28075 | 2007-04-27 |
| 1194845578 | Andrea Jean Dobrich | Chiropractor | 116 Candystick Circle, Harrisburg, NC 28075 | 2007-03-30 |
| Find all providers in zip 28075 | ||||
| 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 |
|---|---|---|---|---|
| 1174826457 | William Michael Mccall | Obstetrics & Gynecology | 417 Trudy Rd, Harrisburg, PA 17109-2927 | 2010-12-08 |
| 1568764181 | Lawrence B. Silver | Obstetrics & Gynecology | 4307 S Victoria Way, Harrisburg, PA 17112-8633 | 2010-12-02 |
| 1376704700 | Manjon Gynecology PC | Obstetrics & Gynecology | 2416 Green Strreet, Harrisburg, PA 17110 | 2008-06-18 |
| 1104048487 | Amber C O'leary | Obstetrics & Gynecology | 121 N Nyes Rd Ste C, Harrisburg, PA 17112-3248 | 2007-05-03 |
| 1912032400 | Michele Alotta | Obstetrics & Gynecology | 8924 St. George's Square, Harrisburg, NC 28075 | 2007-02-23 |
| 1497719587 | Holly J Thomas | Obstetrics & Gynecology | 2645 N 3rd St Fl 4, Harrisburg, PA 17110 | 2006-04-14 |
| 1760443196 | Jean M. Hauser | Obstetrics & Gynecology | 409 S 2nd St, Suite 3f, Harrisburg, PA 17104-1612 | 2006-03-28 |
| 1194703421 | Hanford Ndlovu | Obstetrics & Gynecology | 100 S 2nd St Ste 4a, Harrisburg, PA 17101-2542 | 2006-01-06 |
| 1962497628 | Jose M Manjon | Obstetrics & Gynecology | 4300 Londonderry Rd Ste 305, Harrisburg, PA 17109-5317 | 2005-09-19 |
| 1124635933 | Mason J Carp Md | Obstetrics & Gynecology | 4212 Linglestown Rd, Harrisburg, PA 17112-1025 | 2020-09-25 |
| Find all providers in HARRISBURG | ||||
| City | HARRISBURG |
| Zip Code | 28075 |
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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.