NOVANT MEDICAL GROUP INC (NPI# 1972857449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972857449 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH CATALYST FAMILY & SPORTS MEDICINE |
| Practice Address |
205 Sandalwood Ave Suite A Louisburg NC 27549-2679 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9194973526 |
| Practice Fax Number | 9194973539 |
| Mailing Telephone | 9194973526 |
| Mailing Fax Number | 9194973539 |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2013-08-28 |
| Authorized Official Name | MR. GEOFFERY K GARDNER (VP FINANCE) |
| Authorized Official Telephone | 9194973526 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5921899 | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Catalyst Family & Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1205355799 | Novant Medical Group Inc | Family Medicine | 16525 Holly Crest Ln Ste 250, Huntersville, NC 28078-4912 | 2017-09-15 |
| 1679090468 | Novant Medical Group Inc | Internal Medicine | 12311 Copper Way Ste 100, Charlotte, NC 28277-3643 | 2017-08-23 |
| 1003332016 | Novant Medical Group Inc | Internal Medicine | 10030 Gilead Rd Ste 344, Huntersville, NC 28078-7545 | 2017-08-22 |
| 1255709432 | Novant Medical Group Inc | Family Medicine | 19485 Old Jetton Road, Suite 100, Cornelius, NC 28031-6583 | 2015-09-04 |
| 1215326665 | Novant Medical Group Inc | Surgery | 819 N Atlantic Ave, Southport, NC 28461-3531 | 2015-01-22 |
| 1194113662 | Novant Medical Group Inc | Obstetrics & Gynecology | 1730 Kernersville Medical Parkway, Suite 104, Kernersville, NC 27284-7198 | 2015-01-06 |
| 1437556594 | Novant Medical Group Inc | Internal Medicine | 13 Medical Campus, Suite 102, Supply, NC 28462-4093 | 2014-12-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Novant Medical Group Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Novant Medical Group Inc. | 2085 Frontis Plaza Blvd, Winston Salem, North Carolina 27103 |
| Street Address |
205 SANDALWOOD AVE SUITE A |
| City | LOUISBURG |
| State | NC |
| Zip Code | 27549-2679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427017888 | Warren Allen Blackburn | Family Medicine | 205 Sandalwood Ave, Suite C, Louisburg, NC 27549-2679 | 2006-03-22 |
| 1457655284 | Sasha Celeste Dunbar | Nurse Practitioner | 205 Sandalwood Ave, Suite C, Louisburg, NC 27549-2679 | 2011-01-09 |
| 1740583228 | Novant Medical Group, Inc | Surgery | 205 Sandalwood Ave, Suite B, Louisburg, NC 27549-2679 | 2010-12-06 |
| 1235385915 | Novant Medical Group, Inc. | Family Medicine | 205 Sandalwood Ave, Suite C, Louisburg, NC 27549-2679 | 2008-08-13 |
| 1700040375 | Novant Medical Group Inc | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2008-07-14 |
| 1720281405 | Ekta Patel | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2007-06-08 |
| 1689756975 | David S Seaman | Surgery | 205 Sandalwood Ave, Suite B, Louisburg, NC 27549-2679 | 2006-10-19 |
| 1699780551 | Louisburg Hma Physician Management, LLC | Family Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2006-07-29 |
| 1760419261 | Nicole A Collins | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2006-06-28 |
| 1578590071 | Timothy B Thompson | Internal Medicine | 205 Sandalwood Ave, Suite A, Louisburg, NC 27549-2679 | 2006-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1457816738 | Jasmine Shanta Griffin | Social Worker | Vision Behavioral Health Servicea, 104 North Main St. Suite 200, Louisburg, NC 27549 | 2019-01-31 |
| 1285065797 | Carey Wainwright | Counselor | 104 N. Main Street, Suite 200, Vision Behavioral Health Services, Louisburg, NC 27549 | 2013-12-09 |
| 1114366713 | Alston Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1510 Schloss Road #b, Loiusburg, NC 27549 | 2013-06-18 |
| 1154760981 | Tony's Helping Hand | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 32 Gayline Drive, Louisburg, NC 27549 | 2013-06-14 |
| 1689910192 | E Marie Buie | Counselor | 669 Sagamore, Louisburg, NC 27549 | 2013-01-02 |
| 1508158163 | Julie P Leonard | Pharmacist | 102 N. Bickett Blvd., Louisburg, NC 27549 | 2011-05-13 |
| 1508162678 | Franklin County Department of Social Services | Case Management | 107 Industrial Dr., Suite A, Louisburg, NC 27549 | 2011-02-07 |
| 1134352693 | Howard G Yee, Dmd Pa | Dentist | 311 South Bickett, Louisburg, NC 27549 | 2009-09-01 |
| 1679740203 | Stephen D Perdue | Physical Therapy Assistant | 2176 Nc Hwy 39 North, Louisburg, NC 27549 | 2008-05-13 |
| Find all providers in zip 27549 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1760831028 | William M Sykes | Family Medicine | 129 T.t. Lanier St., Buies Creek, NC 27506 | 2016-06-08 |
| 1730561655 | Brendan Jay Michel | Family Medicine | 437 Little Fisher Trl, Mount Airy, NC 27030-6900 | 2015-06-27 |
| 1699179804 | Carolinas Physicians Network Inc | Family Medicine | 48380 Us Highway 52 N, Misenheimer, NC 28109 | 2014-10-17 |
| 1548509805 | Carolinas Physician Network, Inc. | Family Medicine | 332 North Trade Street, Suite 1200, Matthews, NC 28105-6566 | 2013-02-06 |
| 1699903211 | Robert Alcott | Family Medicine | 6050 W Highway 74, Ste D, Indian Trail, NC 28079-3591 | 2009-06-23 |
| 1962637926 | Thomas Joseph Thekkekandam | Family Medicine | 1635 Nc Highway 66 S, Suite 210, Kernersville, NC 27284-3854 | 2009-05-20 |
| 1477738714 | Forsyth Medical Group, LLC. | Family Medicine | 1900 S Hawthorne Rd Ste 480, Dba Sports Medicine Associates, Winston Salem, NC 27103-3913 | 2008-01-07 |
| 1396938171 | Lawrence M Linett, Md, Pllc | Family Medicine | 431 Western Blvd Ste E, Jacksonville, NC 28546-6823 | 2007-08-24 |
| 1962536516 | Richard T. Ferro | Family Medicine | 6832 Market St, Suite A, Wilmington, NC 28405-9723 | 2007-03-15 |
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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.