NOVANT MEDICAL GROUP, INC. (NPI# 1932109469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932109469 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | MID CAROLINA CARDIOLOGY |
| Practice Address |
1450 Matthews Township Pkwy Suite 380 Matthews NC 28105-2387 |
| Mailing Address |
Po Box 602362 Charlotte NC 28260-2362 |
| Practice Telephone | 7048410772 |
| Practice Fax Number | 7048410775 |
| Mailing Telephone | 7043437840 |
| Enumeration Date | 2005-07-27 |
| 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 | RAILROAD MEDICARE | DG5273 | 01 |
| NC | 5908575 | 05 | |
| SC | NPA577 | 05 | |
| NC | BCBS-NC | 019H6 | 01 |
| 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 |
1450 MATTHEWS TOWNSHIP PKWY SUITE 380 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-2387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649273673 | Todd M Kopczynski | Obstetrics & Gynecology | 1450 Matthews Township Pkwy, Suite 300, Matthews, NC 28105-2387 | 2005-05-23 |
| 1508393927 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy, Suite 320, Matthews, NC 28105-2387 | 2017-05-16 |
| 1932631850 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy, Suite 355, Matthews, NC 28105-2387 | 2017-03-30 |
| 1033566526 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 1450 Matthews Township Pkwy, Suite 410, Matthews, NC 28105-2387 | 2016-05-16 |
| 1134506348 | Novant Health Matthews Medical Center | General Acute Care Hospital | 1450 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-2387 | 2015-04-27 |
| 1053705418 | Suzanne Lake | Speech-Language Pathologist | 1450 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-2387 | 2015-03-24 |
| 1386032647 | Leah Miles Alexander | Physician Assistant | 1450 Matthews Township Pkwy, Suite 250, Matthews, NC 28105-2387 | 2015-01-08 |
| 1225426976 | Novant Health Matthews Medical Center | General Acute Care Hospital | 1450 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-2387 | 2015-01-05 |
| 1063753325 | Novant Medical Group Inc | Obstetrics & Gynecology | 1450 Matthews Township Pkwy, Suite 300, Matthews, NC 28105-2387 | 2013-03-12 |
| 1487906590 | Presbyterian Medical Care Corp | Emergency Medicine | 1450 Matthews Township Pkwy, Suite 170, Matthews, NC 28105-2387 | 2012-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| 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 |
|---|---|---|---|---|
| 1497941025 | Sumit Kalra | Internal Medicine | 1401 Matthews Township Pkwy Ste 110, Matthews, NC 28105-5403 | 2007-09-18 |
| 1407854540 | Laura Leigh H Younce | Internal Medicine | 1401 Matthews Township Pkwy Ste 212, Matthews, NC 28105-5403 | 2005-07-12 |
| 1477073641 | Noant Medical Group, Inc | Internal Medicine | 1401 Matthews Township Pkwy Ste 212, Matthews, NC 28105-5403 | 2017-06-20 |
| 1205170800 | The Presbyterian Hospital | Internal Medicine | 1401 Matthews Township Parkway, Suite 110, Matthews, NC 28105-5403 | 2012-11-20 |
| 1720394927 | Novant Medical Group, Inc | Internal Medicine | 1450 Matthews Township Pkwy, Suite 355, Matthews, NC 28105-4300 | 2010-08-25 |
| 1427374339 | Akshay Pendyal | Internal Medicine | 1401 Matthews Township Pkwy Ste 212, Matthews, NC 28105 | 2010-04-16 |
| 1205800380 | Khawar Mustaq Shaikh | Internal Medicine | 1401 Matthews Township Pkwy, Suite 110, Matthews, NC 28105-5402 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657663 | Cardiosleep Diagnostics | Internal Medicine | 1862 Old Fort Rd, Greenville, NC 27834-9373 | 2020-04-06 |
| 1619467529 | Clerio Francisco De Azevedo Filho | Internal Medicine | 10 Medicine Circle - Duke Medical Pavilion Room 1e50, Durham, NC 27710-0001 | 2018-05-16 |
| 1700385846 | The Presbyterian Hospital | Internal Medicine | 1918 Randolph Rd Ste 820, Charlotte, NC 28207-1119 | 2018-02-05 |
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1225563463 | Benjamin Mcginty Chilcutt | Internal Medicine | 300 Meadowmont Village Cir Ste 104, Chapel Hill, NC 27517-7518 | 2017-04-25 |
| 1437517182 | Regional Physicians LLC | Internal Medicine | 103 W Center St, Lexington, NC 27292 | 2016-02-09 |
| 1982069928 | Four Jewels Healthways | Internal Medicine | 320 Lillington Ave Ste 201, Charlotte, NC 28204-3189 | 2015-12-17 |
| 1932505294 | Donald Frederick Fortin | Internal Medicine | 14001 Weston Pkwy, Suite 101, Cary, NC 27513-2255 | 2014-11-14 |
| 1538564232 | Forsyth Memorial Hospital, Inc | Internal Medicine | 694 Riverside Drive, Mt. Airy, NC 27030-3117 | 2014-10-24 |
| 1710382411 | Forsyth Memorial Hospital, Inc | Internal Medicine | 7114 Villiage Medical Circle, Clemmons, NC 27012 | 2014-10-24 |
| Find all providers with the same taxonomy | ||||
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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.