NOVANT MEDICAL GROUP, INC (NPI# 1790243319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790243319 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Practice Address |
1500 Matthews Township Pkwy Matthews NC 28105-4656 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043846500 |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |
| Authorized Official Name | SHALA DAVIS (MANAGER MANAGED CARE) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Surgical Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
| 1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 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 |
1500 MATTHEWS TOWNSHIP PKWY |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-4656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215928999 | Randell A Hyler | Internal Medicine | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2005-11-02 |
| 1578189478 | Soumyaa Thushyanthan | Physician Assistant | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2020-06-17 |
| 1538715537 | Presbyterian Medical Care Corp | General Acute Care Hospital | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2019-08-15 |
| 1215421656 | Anna Dang | Registered Nurse | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2018-06-19 |
| 1255825972 | Gwen House Mitchell | Pharmacist | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2018-06-16 |
| 1821462078 | Samantha Adcock | Physical Therapist | 1500 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-4656 | 2015-11-25 |
| 1003297342 | Anisha Jones | Registered Nurse | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2015-06-12 |
| 1467839050 | Michelle Easterly | Physical Therapist | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2015-05-03 |
| 1992182778 | Nicole Harkleroad | Physical Therapist | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2015-04-30 |
| 1528445616 | Dana Hoban | Physical Therapist | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2015-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174141683 | Telepartners for Integrated Health | Internal Medicine | 9413 Tillot Dr, Matthews, NC 28105-1567 | 2020-07-10 |
| 1528376712 | Matthews Internal Medicine Pllc | Internal Medicine | 434 N. Trade St, Suite 104, Matthews, NC 28105 | 2010-09-22 |
| 1376726935 | Novant Medical Group, Inc. | Internal Medicine | 3330 Siskey Parkway, Matthews, NC 28105 | 2007-12-06 |
| 1497890891 | Geralyn Mary Campi | Internal Medicine | 2030 Windsor Run Ln, Matthews, NC 28105 | 2007-02-21 |
| 1730103235 | Edward A. Bradford | Internal Medicine | 1450 Matthews Township Pkwy Ste 230, Matthews, NC 28105 | 2006-07-27 |
| 1356367957 | Srinivas Cheruvu | Internal Medicine | 1340 Matthews Township Pkwy Ste 301, Matthews, NC 28105-4681 | 2006-07-15 |
| 1316911159 | Chad Howard | Internal Medicine | 3300 Williams Rd, Matthews, NC 28105 | 2006-02-16 |
| 1235109190 | Kim Marie Foust | Internal Medicine | 1401 Matthews Township Pkwy Ste 200, Matthews, NC 28105-5403 | 2006-01-24 |
| 1215928999 | Randell A Hyler | Internal Medicine | 1500 Matthews Township Pkwy, Matthews, NC 28105-4656 | 2005-11-02 |
| 1215931894 | Eliza N Sangmuah | Internal Medicine | 101 E Matthews Street, Suite 200, Matthews, NC 28105-5373 | 2005-06-10 |
| Find all providers in MATTHEWS | ||||
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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.