NOVANT MEDICAL GROUP, INC (NPI# 1902398985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902398985 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH BRAIN & SPINE SURGERY |
| Practice Address |
152 E Kinderton Way Ste 101 Bermuda Run NC 27006-7351 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3365157336 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847834 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Brain & Spine Surgery | 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 |
152 E KINDERTON WAY STE 101 |
| City | BERMUDA RUN |
| State | NC |
| Zip Code | 27006-7351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144406 | Emily Church Spencer | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2020-04-28 |
| 1124511985 | Novant Medical Group, Inc. | Internal Medicine | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-07 |
| 1265924468 | Novant Medical Group, Inc. | Psychiatry & Neurology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-04 |
| 1326466574 | Kent Cochran | Anesthesiology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2014-04-04 |
| 1124290283 | Kelli Nichols Case | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2008-03-29 |
| 1750585170 | Dittana Phoncharoensri | Psychiatry & Neurology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811567 | Venessa Brunt | Home Health | 271 Orchard Park Drive, Advance, NC 27006 | 2020-08-17 |
| 1730707928 | Dara Elzena Green | Physical Therapist | 142 Hollybrook Dr, Advance, NC 27006 | 2020-07-14 |
| 1104339084 | Mark Curry Maynard | Registered Nurse | 125 W Robin Dr, Advance, NC 27006 | 2017-11-14 |
| 1457781585 | Christa Cook | Physical Therapist | 316 N Carolina 801, Advance, NC 27006 | 2013-11-27 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1073745485 | Digestive Health Specialists, Pa | Internal Medicine | 112 Kinderton Blvd, Advance, NC 27006 | 2009-08-18 |
| 1114101078 | Dr. Todd Carter D.d.s | Dentist | 123 Nc Highway 801 S. #c-100, Advance, NC 27006 | 2007-12-27 |
| 1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
| 1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
| 1104927987 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 260 Highway 801, Advance, NC 27006 | 2006-09-26 |
| Find all providers in zip 27006 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104472125 | Novant Medical Group, Inc. | Neurological Surgery | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-15 |
| 1811492069 | Unc Rockingham Health Care, Inc. | Neurological Surgery | 518 S Van Buren Rd Ste 6, Eden, NC 27288-5017 | 2018-03-29 |
| 1538616289 | Private Diagnostic Clinic, Pllc | Neurological Surgery | 1212 Cedarhurst Dr Ste 102, Raleigh, NC 27609-5588 | 2016-09-09 |
| 1306228028 | Charles Rawlings IIi | Neurological Surgery | 426 Old Salem Rd, Winston Salem, NC 27101-5268 | 2015-06-19 |
| 1790048593 | Edward Yap | Neurological Surgery | 170 Manning Dr, Cb# 7060, Department of Neurosurgery, Chapel Hill, NC 27599-7060 | 2012-06-18 |
| 1588921969 | Thomas Ostergard | Neurological Surgery | 1130 N Church St Ste 200, Greensboro, NC 27401-1041 | 2012-04-23 |
| 1679898548 | Andrew Hall Marky | Neurological Surgery | 7825 Ballantyne Commons Pkwy Ste 150, Charlotte, NC 28277-3175 | 2010-04-02 |
| 1114256468 | William Leonard Sims | Neurological Surgery | 955 37th Ave Ne, Hickory, NC 28601-9609 | 2009-12-16 |
| 1497080006 | Novant Medical Group Inc | Neurological Surgery | 190 Kimel Park Dr Ste 155, Winston Salem, NC 27103-6946 | 2009-10-15 |
| 1205068186 | Jeffrey S Beecher | Neurological Surgery | 2208 S 17th St Ste 201, Wilmington, NC 28401-7594 | 2009-08-11 |
| Find all providers with the same taxonomy | ||||
| City | BERMUDA RUN |
| Zip Code | 27006 |
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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.