NOVANT MEDICAL GROUP, INC. (NPI# 1053878868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053878868 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
106 Langtree Village Dr Ste 200 Mooresville NC 28117-7571 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043164830 |
| Mailing Telephone | 7043164830 |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-02-28 |
| 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 Harbor Pointe OB/GYN | 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 |
106 LANGTREE VILLAGE DR STE 200 |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28117-7571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417937368 | Thomas E Jenike | Family Medicine | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7594 | 2006-01-18 |
| 1699328047 | Novant Medical Group Inc | Internal Medicine | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7571 | 2019-07-24 |
| 1245793546 | Laura Lynn Adkins | Nurse Practitioner | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7571 | 2019-04-12 |
| 1386044527 | Collin Wright | Physician Assistant | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7594 | 2014-08-25 |
| 1174964225 | Jamie Seidl | Family Medicine | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7594 | 2013-07-17 |
| 1184934465 | Natasha Jones | Nurse Practitioner | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117 | 2010-10-20 |
| 1346431806 | Brent Penhall | Family Medicine | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117 | 2007-08-08 |
| 1952403768 | Sharon M Stitt | Nurse Practitioner | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7571 | 2006-09-02 |
| 1376552992 | Victoria K. King | Family Medicine | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7594 | 2006-08-05 |
| 1356311575 | Deborah Parry Warren | Obstetrics & Gynecology | 106 Langtree Village Dr Ste 200, Mooresville, NC 28117-7571 | 2006-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
| 1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
| 1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
| 1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
| 1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
| 1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
| 1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
| 1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
| Find all providers in zip 28117 | ||||
| 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 |
|---|---|---|---|---|
| 1184244881 | Carolinas Physicians Network Inc | Obstetrics & Gynecology | 150 Professional Park Dr Ste 200, Mooresville, NC 28117-5604 | 2020-04-22 |
| 1740544600 | Nicole Sharon Wellbaum | Obstetrics & Gynecology | 131 Medical Park Rd Ste 102, Mooresville, NC 28117-8523 | 2012-06-26 |
| 1477585107 | Todd Jerry Adams | Obstetrics & Gynecology | 235 Medical Park Rd, Suite 201, Mooresville, NC 28117-8545 | 2006-07-06 |
| 1174593313 | James D Wilson | Obstetrics & Gynecology | 131 Medical Park Rd, Ste 102, Mooresville, NC 28117 | 2006-01-23 |
| 1558357079 | Michael Lenwood Boothe | Obstetrics & Gynecology | 1205 Hadley Rd, Mooresville, IN 46158-1737 | 2005-09-20 |
| 1801899901 | Nicole Suzette Perry | Obstetrics & Gynecology | 100 Town Center Rd S, Ste B, Mooresville, IN 46158-2321 | 2005-05-23 |
| 1487012886 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 106 Langtree Village Drive, Suite 200, Mooresville, NC 28117 | 2016-02-01 |
| 1558708032 | Brittany E Johnson | Obstetrics & Gynecology | 1205 Hadley Rd, Mooresville, IN 46158 | 2013-05-24 |
| 1285909002 | Southside Ob/gyn P.C. | Obstetrics & Gynecology | 1205 Hadley Rd, Mooresville, IN 46158-1737 | 2012-03-12 |
| 1659693679 | Neal Edward Ipema | Obstetrics & Gynecology | 100 Town Center Rd S, Suiteb, Mooresville, IN 46158-2321 | 2010-02-17 |
| Find all providers in MOORESVILLE | ||||
| City | MOORESVILLE |
| Zip Code | 28117 |
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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.