NOVANT MEDICAL GROUP, INC. (NPI# 1831199066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831199066 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | MID CAROLINA CARDIOLOGY |
| Practice Address |
2555 Court Dr Ste 300 Gastonia NC 28054-2134 |
| Mailing Address |
Po Box 602362 Charlotte NC 28260-2362 |
| Practice Telephone | 7048683256 |
| Practice Fax Number | 7043323621 |
| Mailing Telephone | 7043847840 |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2011-07-19 |
| Authorized Official Name | GEOFFREY GARDNER (VP OF OPERATIONS) |
| Authorized Official Telephone | 7043849094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS-NC | 019H6 | 01 |
| NC | RAILROAD MEDICARE | DG5273 | 01 |
| NC | 5908575 | 05 | |
| SC | NPA577 | 05 |
| Other Name | Type Code |
|---|---|
| Mid Carolina Cardiology | 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 |
2555 COURT DR STE 300 |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-2134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114925419 | Costa Andreou | Internal Medicine | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2005-07-11 |
| 1518411982 | Courtney Anne Manion | Physician Assistant | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2016-08-15 |
| 1457703837 | Zachary Yates Eaker | Physician Assistant | 2555 Court Dr, Suite #460, Gastonia, NC 28054-2134 | 2016-07-08 |
| 1114375300 | Treneice London | Nurse Practitioner | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2179 | 2016-05-27 |
| 1578933826 | Emily Self | Physician Assistant | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2015-09-30 |
| 1093183642 | Kelly Marie Bergen | Nurse Practitioner | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2015-09-11 |
| 1023400249 | Adnan Ekram | Family Medicine | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2015-02-25 |
| 1760872006 | Danielle Jessen Howell | Physician Assistant | 2555 Court Dr, Suite 400, Gastonia, NC 28054-2134 | 2015-01-26 |
| 1275936502 | Shiddhi P Patel | Family Medicine | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2014-10-01 |
| 1346675501 | Kelly Davis Harris | Nurse Practitioner | 2555 Court Dr, Gastonia, NC 28054-2134 | 2013-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1891793139 | Laddeus L Sutton | Internal Medicine | 2555 Court Dr Ste 200, Gastonia, NC 28054-2178 | 2005-07-11 |
| 1992082879 | Caromont Medical Group Inc | Internal Medicine | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2011-11-07 |
| 1174813224 | Caromont Medical Group Inc | Internal Medicine | 2555 Court Dr, Ste 200, Gastonia, NC 28054-2134 | 2011-04-11 |
| 1700101128 | Carolinas Physicians Network Inc | Internal Medicine | 2550 Court Dr, Suite 203, Gastonia, NC 28054-2152 | 2010-03-29 |
| 1780828681 | Caromont Medical Group Inc | Internal Medicine | 2555 Court Dr, Ste 200, Gastonia, NC 28054-2134 | 2009-04-23 |
| 1164603189 | Caromont Specialty Group LLC | Internal Medicine | 2555 Court Dr, Ste 200, Gastonia, NC 28054-2134 | 2007-11-19 |
| 1306056809 | David Albert Major | Internal Medicine | 2555 Court Dr, Ste 200, Gastonia, NC 28054-2134 | 2007-05-23 |
| 1346252905 | Omer L Shedd | Internal Medicine | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2006-08-12 |
| 1104831858 | Gregory Wesley Woo | Internal Medicine | 2555 Court Dr Ste 200, Gastonia, NC 28054-2178 | 2006-07-30 |
| 1982634994 | Dustin P Letts | Internal Medicine | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2006-07-04 |
| Find all providers in GASTONIA | ||||
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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.