NOVANT MEDICAL GROUP INC (NPI# 1639642614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639642614 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Practice Address |
1219 Lexington Ave Ste B Thomasville NC 27360-2784 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043847680 |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-02 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Neurology and Sleep | 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 |
1219 LEXINGTON AVE STE B |
| City | THOMASVILLE |
| State | NC |
| Zip Code | 27360-2784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528021391 | Gerald Michael Zupruk | Neurological Surgery | 1219 Lexington Ave Ste B, Thomasville, NC 27360-2784 | 2006-04-11 |
| 1457911588 | Novant Medical Group, Inc. | Neurological Surgery | 1219 Lexington Ave Ste B, Thomasville, NC 27360-2784 | 2019-06-20 |
| 1063831907 | Ethan Sungeun Yun | Psychiatry & Neurology | 1219 Lexington Ave Ste B, Thomasville, NC 27360-2784 | 2014-04-08 |
| 1750337929 | Leanne Kay Willis | Psychiatry & Neurology | 1219 Lexington Ave Ste B, Thomasville, NC 27360 | 2006-05-26 |
| 1003861279 | Joseph Keith Miller | Psychiatry & Neurology | 1219 Lexington Ave Ste B, Thomasville, NC 27360 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659994309 | Jazmin Arielle Cromartie | Dentist | 1235 Davidson Community College Rd, Thomasville, NC 27360 | 2020-05-28 |
| 1235609835 | Amekia A Thomas | Counselor | 205 Princeton Xing, Thomasville, NC 27360 | 2018-11-27 |
| 1801340252 | Hospitality Home Care, Inc | Home Health | 508 National Highway, #320, Thomasville, NC 27360 | 2016-08-14 |
| 1629472568 | East Carolina University School of Dental Medicine-davidson | Dentist | 1235 Dccc Road, Thomasville, NC 27360 | 2014-10-21 |
| 1699116723 | Kala Brown Brewer | Optometrist | 1040 Randolph St Ste 14-15, Thomasville, NC 27360 | 2013-07-17 |
| 1740511989 | Cornerstone Health Care LLC | Podiatrist | 211 Old Lexington Road, Thomasville, NC 27360 | 2010-01-28 |
| 1760695472 | Susan Hunter Squires | Counselor | 3954 North Nc Hwy 109, Ledford Middle School School Counselor, Thomasville, NC 27360 | 2007-05-08 |
| 1508961178 | Rebecca Lee Johnson | Social Worker | 17 East Main Street, Thomasville, NC 27360 | 2006-09-14 |
| 1437160124 | Rick H Jackson | Chiropractor | 630 National Highway, Thomasville, NC 27360 | 2006-08-10 |
| 1144253436 | Haresh M Kathard | Family Medicine | 207 Old Lexington Road, Thomasville, NC 27360 | 2006-07-09 |
| Find all providers in zip 27360 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427261262 | Johnson Neurological Clinic, Inc. | Psychiatry & Neurology | 1213 Lexington Ave, Thomasville, NC 27360-3416 | 2007-05-08 |
| 1184671133 | Margaret C. Boltja | Psychiatry & Neurology | 615 S Hansell St, Thomasville, GA 31792-5556 | 2006-05-27 |
| 1730564998 | Archbold Medical Group, Inc | Psychiatry & Neurology | 114 Mimosa Dr, Suite C, Thomasville, GA 31792-6677 | 2015-07-29 |
| 1306225479 | Southern Interventional Pain Center LLC | Psychiatry & Neurology | 615 S Hansell St, Thomasville, GA 31792-5556 | 2015-05-22 |
| 1063831907 | Ethan Sungeun Yun | Psychiatry & Neurology | 1219 Lexington Ave Ste B, Thomasville, NC 27360-2784 | 2014-04-08 |
| 1912202441 | Regional Physicians LLC | Psychiatry & Neurology | 1219 Lexington Ave, Suite B, Thomasville, NC 27360-2870 | 2011-01-13 |
| 1942429485 | Nadir Ismat Ishag Osman | Psychiatry & Neurology | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2007-04-24 |
| 1891873907 | Robert A Lynde | Psychiatry & Neurology | 704 S Broad St, Thomasville, GA 31792-6107 | 2006-11-02 |
| 1750337929 | Leanne Kay Willis | Psychiatry & Neurology | 1219 Lexington Ave Ste B, Thomasville, NC 27360 | 2006-05-26 |
| 1003861279 | Joseph Keith Miller | Psychiatry & Neurology | 1219 Lexington Ave Ste B, Thomasville, NC 27360 | 2006-05-24 |
| Find all providers in THOMASVILLE | ||||
| City | THOMASVILLE |
| Zip Code | 27360 |
Please comment or provide details below to improve the information on NOVANT MEDICAL GROUP INC.
| 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.