NOVANT MEDICAL GROUP INC (NPI# 1700040375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700040375 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH PERRY MEDDERS MEDICAL GROUP |
| Practice Address |
205 Sandalwood Ave Suite A Louisburg NC 27549-2679 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9194964250 |
| Practice Fax Number | 9194961515 |
| Mailing Telephone | 9194964250 |
| Mailing Fax Number | 9194961515 |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2013-11-29 |
| Authorized Official Name | GEOFFREY GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 9194964250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | RAILROAD MEDICARE | CC5118 | 01 |
| NC | 5911436 | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Perry Medders Medical Group | 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 |
205 SANDALWOOD AVE SUITE A |
| City | LOUISBURG |
| State | NC |
| Zip Code | 27549-2679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427017888 | Warren Allen Blackburn | Family Medicine | 205 Sandalwood Ave, Suite C, Louisburg, NC 27549-2679 | 2006-03-22 |
| 1972857449 | Novant Medical Group Inc | Family Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2012-11-05 |
| 1457655284 | Sasha Celeste Dunbar | Nurse Practitioner | 205 Sandalwood Ave, Suite C, Louisburg, NC 27549-2679 | 2011-01-09 |
| 1740583228 | Novant Medical Group, Inc | Surgery | 205 Sandalwood Ave, Suite B, Louisburg, NC 27549-2679 | 2010-12-06 |
| 1235385915 | Novant Medical Group, Inc. | Family Medicine | 205 Sandalwood Ave, Suite C, Louisburg, NC 27549-2679 | 2008-08-13 |
| 1720281405 | Ekta Patel | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2007-06-08 |
| 1689756975 | David S Seaman | Surgery | 205 Sandalwood Ave, Suite B, Louisburg, NC 27549-2679 | 2006-10-19 |
| 1699780551 | Louisburg Hma Physician Management, LLC | Family Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2006-07-29 |
| 1760419261 | Nicole A Collins | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2006-06-28 |
| 1578590071 | Timothy B Thompson | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2006-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1457816738 | Jasmine Shanta Griffin | Social Worker | Vision Behavioral Health Servicea, 104 North Main St. Suite 200, Louisburg, NC 27549 | 2019-01-31 |
| 1285065797 | Carey Wainwright | Counselor | 104 N. Main Street, Suite 200, Vision Behavioral Health Services, Louisburg, NC 27549 | 2013-12-09 |
| 1114366713 | Alston Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1510 Schloss Road #b, Loiusburg, NC 27549 | 2013-06-18 |
| 1154760981 | Tony's Helping Hand | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 32 Gayline Drive, Louisburg, NC 27549 | 2013-06-14 |
| 1689910192 | E Marie Buie | Counselor | 669 Sagamore, Louisburg, NC 27549 | 2013-01-02 |
| 1508158163 | Julie P Leonard | Pharmacist | 102 N. Bickett Blvd., Louisburg, NC 27549 | 2011-05-13 |
| 1508162678 | Franklin County Department of Social Services | Case Management | 107 Industrial Dr., Suite A, Louisburg, NC 27549 | 2011-02-07 |
| 1134352693 | Howard G Yee, Dmd Pa | Dentist | 311 South Bickett, Louisburg, NC 27549 | 2009-09-01 |
| 1679740203 | Stephen D Perdue | Physical Therapy Assistant | 2176 Nc Hwy 39 North, Louisburg, NC 27549 | 2008-05-13 |
| Find all providers in zip 27549 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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. |
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|---|---|---|---|---|
| 1982185377 | Fhpg, LLC | Internal Medicine | 2925 Beechtree Dr, Suite 142, Sanford, NC 27330 | 2018-08-24 |
| 1871034595 | Jane Tramontana | Internal Medicine | 2611 Creek Manor Dr, Waxhaw, NC 28173-4109 | 2017-03-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1154774032 | Roanoke Valley Health Services, Inc | Internal Medicine | 210 Smith Church Rd Ste B, Roanoke Rapids, NC 27870-4942 | 2016-07-15 |
| 1376974485 | Gottskalk Bjornsson | Internal Medicine | 363 Creedmoor Rd, Jacksonville, NC 28546-6035 | 2013-11-29 |
| 1396017752 | Blue Ridge Healthcare Medical Group, Inc. | Internal Medicine | 2293 Sugar Hill Rd, Suite B, Marion, NC 28752-7787 | 2012-02-01 |
| 1518283373 | Christine Lee Vigeland | Internal Medicine | 101 Manning Drive University of North Carolina, Chapel Hill, NC 27599-0001 | 2010-04-19 |
| 1821314014 | Luz Juliana Barahona | Internal Medicine | 706 Rosanne Dr, Kinston, NC 28504-1550 | 2010-04-13 |
| 1407188600 | Blue Ridge Healthcare Medical Group, Inc. | Internal Medicine | 117-b Foothills Dr, Morganton, NC 28655 | 2010-02-12 |
| 1164690731 | Pulmonology & Bronchology | Internal Medicine | 8878 Us 70 Hwy W, Suite 400a, Clayton, NC 27520-4823 | 2008-02-15 |
| Find all providers with the same taxonomy | ||||
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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.