NOVANT MEDICAL GROUP, INC. (NPI# 1770535239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770535239 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH FIRST CHARLOTTE PHYSICIANS EPICENTRE |
| Practice Address |
210 E Trade St Suite D-230 Charlotte NC 28202-2440 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043847085 |
| Practice Fax Number | 7043847089 |
| Mailing Telephone | 7043847085 |
| Mailing Fax Number | 7043847089 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-05-11 |
| Authorized Official Name | GEOFFREY GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847085 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89011JG | 05 | |
| NC | RAILROAD MEDICARE | CC5118 | 01 |
| NC | BCBS-NC | 011JG | 01 |
| Other Name | Type Code |
|---|---|
| Novant Health First Charlotte Physicians EpiCentre | 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 |
210 E TRADE ST SUITE D-230 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28202-2440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407837792 | William R Bullock | Internal Medicine | 210 E Trade St, Suite D-230, Charlotte, NC 28202-2404 | 2005-11-14 |
| 1316545932 | Zorana Prajdic | Pharmacist | 210 E Trade St, Charlotte, NC 28202-2404 | 2020-10-15 |
| 1063932473 | Ivey Thompson | Nurse Practitioner | 210 E Trade St, Charlotte, NC 28202-2404 | 2017-06-27 |
| 1619320199 | Kayley Sebastian | Pharmacist | 210 E Trade St, Suite E-186, Charlotte, NC 28202-2404 | 2016-07-19 |
| 1265828669 | Seti Yemane-byrd Dmd, P.a. | Dentist | 210 E Trade St, E-484, Charlotte, NC 28202-2404 | 2015-04-13 |
| 1780025122 | Zachary Weitzel | Pharmacist | 210 E Trade St, Suite E-186, Charlotte, NC 28202-2404 | 2013-07-15 |
| 1790088110 | Terrie Ammons Rallings | Pharmacist | 210 E Trade St, Charlotte, NC 28202-2404 | 2010-12-07 |
| 1710280250 | Carolyn Henry | Pharmacist | 210 E Trade St, Charlotte, NC 28202-2404 | 2010-12-06 |
| 1669423687 | Harold Dowe Albright IIi | Internal Medicine | 210 E Trade St, Suite D230, Charlotte, NC 28202-2404 | 2006-05-15 |
| 1174588115 | Coleman D Carter | Internal Medicine | 210 E Trade St, Suite D-230, Charlotte, NC 28202-2404 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609418425 | Monarch | Community/Behavioral Health | 215 North Pine Street Unit 705, Charlotte, NC 28202 | 2019-10-14 |
| 1396211892 | Brooke Graham | Behavior Technician | 107 New Edition Court Carey, Raleigh, NC 28202 | 2018-10-23 |
| 1740704352 | Targetcare, Inc. | Health Educator | 831 E. Morehead Street, Suite 900, Charlotte, NC 28202 | 2017-07-26 |
| 1659828291 | Reserve Health, PC | Family Medicine | 135 W 10th St, Charlotte, NC 28202 | 2016-09-01 |
| 1275905887 | Tameka Wade Brewington | Counselor | 615 E 6th St Ste 112, Charlotte, NC 28202 | 2015-10-22 |
| 1962815159 | Teisha Miller | Social Worker | 700 N. Tryon Street, Charlotte, NC 28202 | 2014-06-05 |
| 1699193672 | Elizabeth Ann Peterson-vita | Psychologist | 700 East Stonewall Street, Suite 714, Charlotte, NC 28202 | 2014-04-07 |
| 1942631437 | Avery Sales | Durable Medical Equipment & Medical Supplies | 103 W Morehead St, Charlotte, NC 28202 | 2013-12-09 |
| 1801236484 | Annette Goodman | Counselor | 415 E. Trade Street, Charlotte, NC 28202 | 2013-06-27 |
| 1174960181 | Jennifer D'silva | Dentist | 210 E Trade St # 484, Charlotte, NC 28202 | 2013-05-30 |
| Find all providers in zip 28202 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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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|---|---|---|---|---|
| 1932722980 | Carolinas Physicians Network Inc | Internal Medicine | 2041 South Blvd, Ste 100, Charlotte, NC 28203-5062 | 2020-05-26 |
| 1538700745 | Geriatric Care of The Carolinas, Pllc | Internal Medicine | 6001 Graburns Ford Dr, Charlotte, NC 28269-7120 | 2019-09-30 |
| 1477100683 | Carolinas Physicians Network Inc | Internal Medicine | 9325 Jw Clay Blvd, Ste 221, Charlotte, NC 28262-5411 | 2019-08-22 |
| 1972169977 | Iora Health North Carolina, P.C. | Internal Medicine | 8332 Pineville Matthews Rd Ste 205, Charlotte, NC 28226-3765 | 2019-05-15 |
| 1700345105 | Carolinas Physicians Network Inc | Internal Medicine | 2109 Randolph Rd, Charlotte, NC 28207-1521 | 2019-03-15 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1588166060 | Allcare Medical Center,pllc | Internal Medicine | 7401 The Plaza, Charlotte, NC 28215 | 2018-03-01 |
| 1083137616 | Sc Med LLC | Internal Medicine | 10436 Winslet Dr, Charlotte, NC 28277-2956 | 2017-07-25 |
| 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.