NOVANT MEDICAL GROUP, INC. (NPI# 1962969774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962969774 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH SOUTH LAKE OB/GYN |
| Practice Address |
9955 Poplar Tent Rd Concord NC 28027-9304 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043164828 |
| Practice Fax Number | 7043164829 |
| Mailing Telephone | 7043164830 |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health South Lake OB/GYN | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6909 Prosperity Church Rd, Huntersville, NC 280786698 | 7043164830 |
| 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 |
9955 POPLAR TENT RD |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-9304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316905391 | Cynthia Wesley | Obstetrics & Gynecology | 9955 Poplar Tent Rd, Concord, NC 28027 | 2006-05-01 |
| 1801362660 | Novant Medical Group, Inc. | Family Medicine | 9955 Poplar Tent Rd, Concord, NC 28027-9314 | 2018-10-19 |
| 1922538503 | Jacqueline Katrina Watson | Family Medicine | 9955 Poplar Tent Rd, Concord, NC 28027-9314 | 2017-06-15 |
| 1124404686 | Hang Linda Hoang | Nurse Practitioner | 9955 Poplar Tent Rd, Concord, NC 28027-9304 | 2015-08-07 |
| 1891180105 | Ashikaben Patel | Obstetrics & Gynecology | 9955 Poplar Tent Rd, Concord, NC 28027-9314 | 2015-04-02 |
| 1235222704 | Margaret Stephanie Dutton | Obstetrics & Gynecology | 9955 Poplar Tent Rd, Concord, NC 28027-9314 | 2006-10-02 |
| 1215953054 | Trang Vuong | Internal Medicine | 9955 Poplar Tent Rd, Concord, NC 28027-9304 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023652252 | Medcare Transport of Nc | Non-emergency Medical Transport (VAN) | 7039 Northwinds Dr Nw, Unit C, Concord, NC 28027 | 2019-10-31 |
| 1538718770 | Carolyn Ann Broadnax | Technician | 3524 Cedar Springs Dr, Concord, NC 28027 | 2019-09-10 |
| 1447806575 | Claire-ann E Papp | Dentist | 8815 Christenbury Parkway, Suite 40, Concord, NC 28027 | 2019-08-14 |
| 1578120218 | Philip Osborn | Dentist | 5408 Nc-49, Harrisburg, NC 28027 | 2019-05-28 |
| 1639648306 | Kristen Morris Spell | Counselor | 195 Lower Cape Dr Sw Apt 107, Concord, NC 28027 | 2018-11-25 |
| 1568959625 | Laurie Ford | Counselor | 705 Samuel Adams Cir Sw, Concord, NC 28027 | 2018-04-15 |
| 1598278194 | Autumn Nobles | Specialist/Technologist | 10193 Falling Leaf Dr Nw, Concord, NC 28027 | 2017-11-06 |
| 1386192938 | Brundasudha Satti IIi | Physical Therapist | 379 Sutoforest Dr Nw, Concord, NC 28027 | 2016-09-12 |
| 1467809616 | Kathryn Teal Watts | Dentist | 5305345 Vining St Nw, #201, Concord, NC 28027 | 2016-05-18 |
| 1720443849 | Denette Carte | Health Educator | 9712 Ravenscroft Lane Nw, Concord, NC 28027 | 2015-12-16 |
| Find all providers in zip 28027 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508220773 | Vivian Ojeda | Obstetrics & Gynecology | 246 Pleasant St, Memorail Building, West, Floor 1, Concord, NH 03301-2548 | 2016-04-13 |
| 1265758460 | John A Crockett Md A Professional Corporation | Obstetrics & Gynecology | 2485 High School Ave Ste 303, Concord, CA 94520-1818 | 2010-04-13 |
| 1730335910 | Joanne A. Schoen | Obstetrics & Gynecology | 7625 Gentry Circle, Concord, OH 44077 | 2008-08-07 |
| 1790806941 | Kenneth J Hekman | Obstetrics & Gynecology | 277 Deacon Haynes Rd, Concord, MA 01742-4757 | 2007-04-03 |
| 1891895686 | Anita K Rama, Md, Inc. | Obstetrics & Gynecology | 2425 East Street #14, Concord, CA 94520 | 2006-09-22 |
| 1285645556 | Mary Lucia | Obstetrics & Gynecology | 131 Old Road To 9 Acre Cor Ste 830, Concord, MA 01742-4191 | 2006-08-11 |
| 1902822083 | Chung Hwa Yi | Obstetrics & Gynecology | 246 Pleasant Street Memorial Building, West, Floor 1, Concord, NH 03301-5046 | 2006-07-14 |
| 1003854993 | Rebecca Anne Ewing | Obstetrics & Gynecology | 3 N State St, Concord, NH 03301-4037 | 2006-06-03 |
| 1811955628 | Timothy K Hale | Obstetrics & Gynecology | 131 Ornac Suite 430, Kramer Ob Gyn Emerson Hospital, Concord, MA 01742 | 2006-05-02 |
| 1316905391 | Cynthia Wesley | Obstetrics & Gynecology | 9955 Poplar Tent Rd, Concord, NC 28027 | 2006-05-01 |
| Find all providers in CONCORD | ||||
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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.