NOVANT MEDICAL GROUP, INC. (NPI# 1871747345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871747345 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH HARBORSIDE PEDIATRICS |
| Practice Address |
133 Welton Way Suite C Mooresville NC 28117-9163 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7046642552 |
| Practice Fax Number | 7046645382 |
| Mailing Telephone | 7046642552 |
| Mailing Fax Number | 7046645382 |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2013-07-26 |
| Authorized Official Name | GEOFFERY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Harborside Pediatrics | 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 |
133 WELTON WAY SUITE C |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28117-9163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104891902 | Shelley H. Rinker | Pediatrics | 133 Welton Way, Suite C, Mooresville, NC 28117 | 2006-02-23 |
| 1861939266 | Kelly Beth Williams | Nurse Practitioner | 133 Welton Way, Suite C, Mooresville, NC 28117-9163 | 2017-01-23 |
| 1548494792 | Laura De Leon | Nurse Practitioner | 133 Welton Way, Suite C, Mooresville, NC 28117-9163 | 2009-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
| 1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
| 1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
| 1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
| 1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
| 1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
| 1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
| 1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
| Find all providers in zip 28117 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649624529 | Corin Marshall | Pediatrics | 1001 Hadley Rd Ste Ll050, Mooresville, IN 46158-1883 | 2016-04-18 |
| 1235347378 | Northlake Children's Associates, P.a. | Pediatrics | 170a Medical Park Rd, Suite 102, Mooresville, NC 28117 | 2007-05-21 |
| 1083783245 | Stephen J Malloney | Pediatrics | 134 Medical Park Rd Ste 100, Mooresville, NC 28117-8527 | 2006-11-06 |
| 1356357727 | Mooresville Hma Physician Management, Inc. | Pediatrics | 207 S Broad St, Ste 5, Mooresville, NC 28115-3500 | 2006-07-31 |
| 1457396707 | Sidney L Gilbert | Pediatrics | 100 Town Center Drive, Suite B, Mooresville, IN 46158 | 2006-06-19 |
| 1073566014 | Elizabeth Ellen Tilt | Pediatrics | 136 Gateway Blvd Ste A, Mooresville, NC 28117-5608 | 2006-05-19 |
| 1104891902 | Shelley H. Rinker | Pediatrics | 133 Welton Way, Suite C, Mooresville, NC 28117 | 2006-02-23 |
| 1083698005 | Gianna Demos Madrid | Pediatrics | 656 Carpenter Ave, Mooresville, NC 28115-2538 | 2005-12-02 |
| 1275006835 | Piedmont Healthcare, Pa | Pediatrics | 128 Medical Park Rd Ste 200, Mooresville, NC 28117-8579 | 2019-01-07 |
| 1578057394 | Novant Medical Group, Inc. | Pediatrics | 656 Carpenter Ave, Mooresville, NC 28115-2538 | 2018-06-15 |
| Find all providers in MOORESVILLE | ||||
| City | MOORESVILLE |
| Zip Code | 28117 |
Please comment or provide details below to improve the information on NOVANT MEDICAL GROUP, INC..
| 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.