NOVANT MEDICAL GROUP, INC (NPI# 1942729439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942729439 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH HEMATOLOGY |
| Practice Address |
1718 E 4th St Ste 807 Charlotte NC 28204-3280 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043163297 |
| Practice Fax Number | 7043163298 |
| Mailing Telephone | 7043847840 |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2017-10-12 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043841900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Hematology | 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 |
1718 E 4TH ST STE 807 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447424197 | Kimberly Michelle Green | Internal Medicine | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2008-04-14 |
| 1851953285 | Roseann Marie Barrera | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2019-07-06 |
| 1043877574 | Brittany Ann Kober | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2019-05-21 |
| 1518520238 | Mallory Brooke Johnson | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2019-04-18 |
| 1821597725 | Angeliki Evangelia Raptis | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204 | 2018-02-06 |
| 1497192728 | Jenny Park | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2013-05-28 |
| 1437499506 | Mary E Dilorenzo | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2013-02-26 |
| 1366754954 | Alan P. Zausner Skarbnik | Internal Medicine | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2010-07-12 |
| 1679806566 | Mary Catherine Meadows | Physician Assistant | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2009-09-10 |
| 1386804409 | Omotayo Olusola Fasan | Internal Medicine | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2008-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 207RH0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology |
| An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1982038683 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 15830 Ballantyne Medical Pl, Suite 200, Charlotte, NC 28277-4653 | 2013-08-29 |
| 1861826562 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 101 E W T Harris Blvd, Ste 5500, Charlotte, NC 28262-3485 | 2013-08-29 |
| 1245561554 | Carolinas Hematology-oncology Associates | Internal Medicine | 15830 John J. Delaney Drive, Ste 200, Charlotte, NC 28277-3297 | 2010-01-26 |
| 1417105941 | Shebli Atrash | Internal Medicine | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2008-09-09 |
| 1649447426 | Emiliano Mugnaini | Internal Medicine | 1021 Morehead Medical Dr, Suite A, Charlotte, NC 28204-2990 | 2008-05-12 |
| 1356541445 | Nilay Shah | Internal Medicine | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2007-07-18 |
| 1275679201 | Jonathan Gerber | Internal Medicine | 1021 Morehead Medical Dr, Suite A, Charlotte, NC 28204-2990 | 2007-01-29 |
| 1457412454 | Peter Voorhees | Internal Medicine | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2006-12-13 |
| 1992720494 | Charles Packman | Internal Medicine | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2006-07-13 |
| 1356326664 | Yinlee Yoong | Internal Medicine | 1021 Morehead Medical Dr, Suite A, Charlotte, NC 28204-2990 | 2005-12-08 |
| Find all providers in CHARLOTTE | ||||
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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.