NOVANT MEDICAL GROUP, INC. (NPI# 1710547369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710547369 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH ADULT PRIMARY CARE TANGLEWOOD |
| Practice Address |
4136 Clemmons Rd Clemmons NC 27012-7520 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3368933270 |
| Practice Fax Number | 3368933279 |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-19 |
| Authorized Official Name | SHALA DAVIS (RCS MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Adult Primary Care Tanglewood | 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 |
4136 CLEMMONS RD |
| City | CLEMMONS |
| State | NC |
| Zip Code | 27012-7520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489314 | Steven Edward Helman | Internal Medicine | 4136 Clemmons Rd, Clemmons, NC 27012-7520 | 2005-06-28 |
| 1083249437 | Kathryn Elizabeth Brockway | Physician Assistant | 4136 Clemmons Rd, Clemmons, NC 27012-7520 | 2020-03-05 |
| 1184070237 | Rebecca Faith Myers | Physician Assistant | 4136 Clemmons Rd, Clemmons, NC 27012 | 2016-05-09 |
| 1649512922 | Carolina Medicorp Enterprises, Inc | Family Medicine | 4136 Clemmons Rd, Clemmons, NC 27012-7520 | 2013-03-25 |
| 1992787501 | Danielle Marguerite Carter Adkins | Physician Assistant | 4136 Clemmons Rd, Clemmons, NC 27012-7520 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427697978 | Novant Health Clemmons Outpatient Surgery, LLC | Nurse Anesthetist, Certified Registered | 7210 Village Medical Circel, Ste 235, Clemmons, NC 27012 | 2020-01-02 |
| 1528521887 | Novant Health Clemmons Outpatient Surgery, LLC | Clinic/Center | 7210 Village Medical Circle, Suite # 235, Clemmons, NC 27012 | 2019-04-12 |
| 1710382411 | Forsyth Memorial Hospital, Inc | Internal Medicine | 7114 Villiage Medical Circle, Clemmons, NC 27012 | 2014-10-24 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 1912323635 | Lutheran Home - Forsyth County, Inc. | Skilled Nursing Facility | 7449 Fair Oaks Drive, Clemmons, NC 27012 | 2014-03-06 |
| 1487910758 | Kelly Elizabeth Kirkpatrick | Specialist/Technologist | 1735 Lewisville Clemmons Road, West Forsyth High School, Clemmons, NC 27012 | 2012-04-11 |
| 1366613663 | Psimed Pa | Psychiatry & Neurology | 2511-d Neudorf Rd, Clemmons, NC 27012 | 2008-03-14 |
| 1871797688 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 5175 Old Clemmons School Road, Clemmons, NC 27012 | 2007-06-14 |
| 1700970878 | Thomas M Anderson Dds Pa | Clinic/Center | 2245 Lewisville Clemmons Road Suite B, Clemmons, NC 27012 | 2006-10-03 |
| 1902998941 | Steven A Cuccia Dds Pa | Dentist | 2265 Lewisville Clemmons Rd, Suite A, Clemmons, NC 27012 | 2006-09-28 |
| Find all providers in zip 27012 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518141407 | Clemmons Urgent and Primary Care, Pa | Family Medicine | 2245 Lewisville Clemmons Rd Ste C, Clemmons, NC 27012-7461 | 2007-12-27 |
| 1871797688 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 5175 Old Clemmons School Road, Clemmons, NC 27012 | 2007-06-14 |
| 1346208113 | Travis Worth Howell | Family Medicine | 7130 Village Medical Cir, Clemmons, NC 27012 | 2006-05-02 |
| 1629064191 | Arie Mantin | Family Medicine | 2245 Lewisville Clemmons Rd, Clemmons, NC 27012-7461 | 2005-09-21 |
| 1205473261 | Novant Medical Group. Inc. | Family Medicine | 7130 Village Medical Cir, Clemmons, NC 27012-8004 | 2019-12-09 |
| 1629506449 | Novant Medical Group, Inc | Family Medicine | 6915 Village Medical Cir, Clemmons, NC 27012-8002 | 2017-05-24 |
| 1114332293 | Forsyth Memorial Hospital | Family Medicine | 7130 Village Medical Cir, Clemmons, NC 27012-8004 | 2014-06-26 |
| 1972915510 | Piedmont Community Physicians PC | Family Medicine | 3610 Darren Rd, Clemmons, NC 27012-9077 | 2014-06-02 |
| 1386056067 | David M Villanueva | Family Medicine | 2311 Lewisville Clemmons Rd, Clemmons, NC 27012-8905 | 2014-05-29 |
| 1649512922 | Carolina Medicorp Enterprises, Inc | Family Medicine | 4136 Clemmons Rd, Clemmons, NC 27012-7520 | 2013-03-25 |
| Find all providers in CLEMMONS | ||||
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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.