NOVANT MEDICAL GROUP, INC (NPI# 1881994903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881994903 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | CAROLINA FAMILY PRACTICE AND SPORTS MEDICINE |
| Practice Address |
190 Rosewood Centre Dr Suite 100 Holly Springs NC 27540-7628 |
| Mailing Address |
Po Box 602362 Charlotte NC 28260-2362 |
| Practice Telephone | 9192382000 |
| Practice Fax Number | 9192385010 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2011-05-05 |
| Authorized Official Name | MR. GEOFFREY GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043849094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Carolina Family Practice and Sports Medicine | 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 |
190 ROSEWOOD CENTRE DR SUITE 100 |
| City | HOLLY SPRINGS |
| State | NC |
| Zip Code | 27540-7628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700813466 | Meredith Duckworth Taylor | Dentist | 190 Rosewood Centre Dr, Suite #200, Holly Springs, NC 27540-9451 | 2006-06-27 |
| 1770901597 | Elena Alexandrovna Kramarenko | Physical Therapist | 190 Rosewood Centre Dr, Suite 101, Holly Springs, NC 27540-7628 | 2014-03-29 |
| 1861741233 | Private Diagnostic Clinic, Pllc | Family Medicine | 190 Rosewood Centre Dr, Ste. 100, Holly Springs, NC 27540-7628 | 2012-08-31 |
| 1346505138 | Daniel Jason Fitzgerald | Specialist/Technologist | 190 Rosewood Centre Dr, Suite 100, Holly Springs, NC 27540-7628 | 2012-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528612785 | Marina Isabel Mckeown | Speech-Language Pathologist | 1140 W Savannah Ridge Rd, Suite 111, Holly Springs, NC 27540 | 2019-07-26 |
| 1912474784 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 1004 Werrington Drive, Suite 300, Holly Springs, NC 27540 | 2018-10-30 |
| 1699240937 | Kristen Shrum | Family Medicine | 401 Irving Parkway, Holly Springs, NC 27540 | 2018-10-12 |
| 1508369109 | Shannon Silsby | Nurse Practitioner | 1004 Werrington Dr Ste 200, Holly Springs, NC 27540 | 2018-03-10 |
| 1790212306 | Alex Nolan | Speech-Language Pathologist | 251 Center Street, Holly Springs, NC 27540 | 2017-05-12 |
| 1386190957 | Holly Springs Surgery Center, LLC | Clinic/Center | 600 Village Walk Drive, Holly Springs, NC 27540 | 2016-09-01 |
| 1568827723 | Leslie Clark Lively | Speech-Language Pathologist | 1140 W. Savannah Ridge Road, Suite 111, Holly Springs, NC 27540 | 2015-12-15 |
| 1124410667 | Back In Action of Holly Springs, Inc | Physical Therapist | 500 Village Walk Dr., Holly Springs, NC 27540 | 2015-02-20 |
| 1033559018 | Andrew John Krieger | Emergency Medicine | 5405 Bluet Ct, Holly Springs, NC 27540 | 2013-07-05 |
| 1598104200 | Atkins Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 144 Adrian Street, Holly Springs, NC 27540 | 2013-06-17 |
| Find all providers in zip 27540 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699240937 | Kristen Shrum | Family Medicine | 401 Irving Parkway, Holly Springs, NC 27540 | 2018-10-12 |
| 1124460985 | Life Source, PC | Family Medicine | 1108 Kentworth Dr, Suite 704, Holly Springs, NC 27540-3325 | 2013-07-22 |
| 1861797235 | Urgent Cares of America North Carolina Inc | Family Medicine | 104 Bass Lake Rd, Suite B-2, Holly Springs, NC 27540-7620 | 2011-01-17 |
| 1184936684 | Daquesha Capre Chever | Family Medicine | 1120 Wellstar Way Ste 105, Holly Springs, GA 30114 | 2010-07-13 |
| 1265752364 | Village Family Practice of Holly Springs Pllc | Family Medicine | 351 W. Center Street, Holly Springs, NC 27540-5902 | 2010-06-11 |
| 1225185507 | Holly Springs Medical Center, Pa | Family Medicine | 500 Holly Springs Road, Suite #100, Holly Springs, NC 27540-6204 | 2007-01-05 |
| 1275632945 | Chaitany R Patel | Family Medicine | 107 Hyannis Dr, Holly Springs, NC 27540-8336 | 2006-09-21 |
| 1093823874 | Samreen Azeem | Family Medicine | 5233 Sunset Lake Rd, Holly Springs, NC 27540-3793 | 2006-08-29 |
| 1760433817 | Thomas Kenneth Warcup | Family Medicine | 208 Village Walk Dr, Suite C140, Holly Springs, NC 27540-7681 | 2006-05-13 |
| 1417913120 | Phyllis Renee Wright | Family Medicine | 153a S Market St, Holly Springs, MS 38635-3029 | 2006-04-21 |
| Find all providers in HOLLY SPRINGS | ||||
| City | HOLLY SPRINGS |
| Zip Code | 27540 |
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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.