NOVANT MEDICAL GROUP, INC. (NPI# 1881707487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881707487 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | SOUTHEAST CHILDREN'S UROLOGY |
| Practice Address |
16525 Holly Crest Ln Suite 230 Huntersville NC 28078-4909 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165140 |
| Practice Fax Number | 7043165145 |
| Mailing Telephone | 7043847840 |
| Mailing Fax Number | 7043847830 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-08-18 |
| Authorized Official Name | DINESH S PAI (VP OF OPERATIONS) |
| Authorized Official Telephone | 7043849104 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5904654 | 05 | |
| SC | NPB185 | 05 | |
| NC | BCBS | 018J1 | 01 |
| Other Name | Type Code |
|---|---|
| Southeast Children's Urology | 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 |
16525 HOLLY CREST LN SUITE 230 |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-4909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821060245 | Loveleen K Barringer | Family Medicine | 16525 Holly Crest Ln, Suite 150, Huntersville, NC 28078-4909 | 2006-02-02 |
| 1245785021 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 16525 Holly Crest Ln, Suite 250, Huntersville, NC 28078-4909 | 2016-08-22 |
| 1821473265 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 16525 Holly Crest Ln, Suite 250, Huntersville, NC 28078-4909 | 2015-07-28 |
| 1033559299 | Matthew W Lineberger | Dentist | 16525 Holly Crest Ln, Suite 250, Huntersville, NC 28078-4909 | 2013-07-02 |
| 1780024018 | Jason Andrew Diehl | Physician Assistant | 16525 Holly Crest Ln, Suite 120, Huntersville, NC 28078-4909 | 2013-07-01 |
| 1629373261 | Leigh-taylor Austin | Nurse Practitioner | 16525 Holly Crest Ln, Ste 150, Huntersville, NC 28078-4909 | 2011-01-12 |
| 1144534942 | Novant Medical Group Inc | Psychiatry & Neurology | 16525 Holly Crest Ln, Suite 210, Huntersville, NC 28078-4912 | 2010-08-04 |
| 1821248196 | Novant Medical Group, Inc. | Psychiatry & Neurology | 16525 Holly Crest Ln, Suite 120, Huntersville, NC 28078-4909 | 2008-09-24 |
| 1710008636 | Thomas A. Brown | Dentist | 16525 Holly Crest Ln, Suite 250, Huntersville, NC 28078-4909 | 2007-04-02 |
| 1386719367 | Janet M. Laursen | Dietitian, Registered | 16525 Holly Crest Ln, Suite 150, Huntersville, NC 28078-4909 | 2006-11-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787718 | John M. Bakarich, Dds, Pllc | Dentist | 15810 Northcross Drive, Suite A, Huntersville, NC 28078 | 2020-07-14 |
| 1316587082 | Blake Allen Klessig | Chiropractor | 8936 Northpointe Executive Park Dr, Suite 195, Huntersville, NC 28078 | 2020-01-10 |
| 1922644830 | Steven James Underwood | Physical Therapist | Aldersgate Ccrc, 3800 Shamrock Drive, Charlotte, NC 28078 | 2019-11-26 |
| 1851856306 | Jessica Runnion | Behavior Technician | 14625 Reese Blvd, Apartment 208, Huntersville, NC 28078 | 2019-02-08 |
| 1568935401 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 111 Commerce Centre Drive, Suite 305, Huntersville, NC 28078 | 2019-01-03 |
| 1932691763 | Shakira Grier | Massage Therapist | 15905 Brookway Drive, Ste 4202, Huntersville, NC 28078 | 2018-06-06 |
| 1457850596 | Chudney Drew | Counselor | 10224 Hickorywood Hill Ave Ste 201, Huntersville, NC 28078 | 2018-02-05 |
| 1215457122 | Amy Nicole Castongia | Counselor | 10511 Drake Hill Dr, Huntersville, NC 28078 | 2017-06-21 |
| 1457714057 | Robin D Disbro | Registered Nurse | 6216 Colonial Garden Drive, Huntersville, NC 28078 | 2016-03-31 |
| 1144695545 | Huntersville H&r Ops Limited Partnership | Skilled Nursing Facility | 13835 Boren Street, Huntersville, NC 28078 | 2015-12-10 |
| Find all providers in zip 28078 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306169768 | Carolinas Physicians Network, Inc. | Urology | 9625 Northcross Center Ct, Suite 102, Huntersville, NC 28078-7348 | 2010-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164678819 | Scott A. Berkman, Md, Plc | Urology | 17332 Newlands Corner Lane, Charlotte, NC 28277-1073 | 2008-08-13 |
| 1356880801 | Carolinas Physicians Network Inc | Urology | 1025 Morehead Medical Dr, Ste 275, Charlotte, NC 28204-2963 | 2017-02-16 |
| 1861715245 | Carolinas Physicians Network Inc | Urology | 101 E W T Harris Blvd, Suite 3301, Charlotte, NC 28262-3485 | 2010-03-12 |
| 1780907220 | Carolinas Physicians Network Inc | Urology | 50 Hospital Dr, Suite 1c, Hendersonville, NC 28792-5248 | 2010-03-11 |
| 1114240652 | Carolinas Physicians Network, Inc. | Urology | 100 Medical Park Drive, Suite 310, Concord, NC 28025-2966 | 2010-03-11 |
| 1447573209 | Carolinas Physicians Network Inc | Urology | 1001 Blythe Blvd, Suite 200, Charlotte, NC 28203-5866 | 2010-03-09 |
| 1376866129 | Carolinas Physicians Network, Inc. | Urology | 1781 Tate Blvd Se, Hickory, NC 28602-4251 | 2010-03-09 |
| 1871713859 | Joseph A. Molitierno Jr. | Urology | 3125 Springbank Ln, Suite E, Charlotte, NC 28226-3379 | 2007-05-01 |
| 1952434672 | Carolinas Physicians Network, Inc. | Urology | 3125 Springbank Ln, Suite E, Charlotte, NC 28226-3378 | 2007-03-13 |
| 1851496392 | Mark Williams | Urology | 1025 Morehead Medical Dr, Ste 275, Charlotte, NC 28204-2963 | 2006-09-13 |
| Find all providers with the same taxonomy | ||||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
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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.