NOVANT MEDICAL GROUP, INC (NPI# 1063906089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063906089 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH CANCER INSTITUTE |
| Practice Address |
8201 Healthcare Loop Ste 201 Charlotte NC 28215-7072 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9803022000 |
| Practice Fax Number | 9803022020 |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | SHALA DAVIS (RCS MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Cancer Institute | Doing Business As Name - Organization |
| Novant Health Cancer Specialists | 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 |
8201 HEALTHCARE LOOP STE 201 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28215-7072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417046343 | Jennifer Lauren Dallas | Internal Medicine | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2006-10-11 |
| 1780145391 | Novant Medical Group, Inc. | Neurological Surgery | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2019-03-27 |
| 1538653555 | Novant Medical Group, Inc | Psychiatry & Neurology | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1225522246 | Novant Medical Group, Inc | Psychiatry & Neurology | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1093228827 | Meghan Leigh Mcinnis | Nurse Practitioner | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2017-11-15 |
| 1720590185 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2017-10-25 |
| 1265878680 | Kristina May Shaffer | Surgery | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2013-05-13 |
| 1821264169 | Lilian M. Harris | Specialist | 8201 Healthcare Loop Ste 201, Charlotte, NC 28215-7072 | 2008-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679111769 | Lawana Ussery Hill | Case Management | 1740 Misty Morn Drive, Charlotte, NC 28215 | 2019-12-19 |
| 1053961110 | Tonya Anita Brown | Behavior Technician | 10230 White Oak Rd, Charlotte, NC 28215 | 2019-09-19 |
| 1780242412 | Mikhail A Rybin | Registered Nurse | 7502 Malden Park Drive, Charlotte, NC 28215 | 2019-05-29 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1538646088 | Andrew Simpson | Pharmacist | 3805 Rocky River Rd, Charlotte, NC 28215 | 2018-07-26 |
| 1154818425 | Korinne A Umlauft | Specialist/Technologist | 8618 Terra Cotta Dr, Charlotte, NC 28215 | 2018-04-22 |
| 1477058196 | Harmony Health Pllc | Community/Behavioral Health | 8633 Pine Circle, Charlotte, NC 28215 | 2018-03-26 |
| 1639671357 | Total Renal Care of North Carolina LLC | Clinic/Center | 9562 Rocky River Rd, Charlotte, NC 28215 | 2018-03-08 |
| 1588166060 | Allcare Medical Center,pllc | Internal Medicine | 7401 The Plaza, Charlotte, NC 28215 | 2018-03-01 |
| 1851891774 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 3211 Bishops Way Lane, Charlotte, NC 28215 | 2018-02-16 |
| Find all providers in zip 28215 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851909816 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 660, Charlotte, NC 28204-3215 | 2020-07-16 |
| 1346858487 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 560, Charlotte, NC 28204-3215 | 2020-07-15 |
| 1295343341 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 640, Charlotte, NC 28204-3215 | 2020-07-15 |
| 1881212215 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 520, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1720606486 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 400, Charlotte, NC 28204-3215 | 2020-07-09 |
| 1720606445 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 430, Charlotte, NC 28204-3215 | 2020-07-09 |
| 1235757352 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 420, Charlotte, NC 28204-3215 | 2020-07-07 |
| 1174989479 | The Presbyterian Hospital | Internal Medicine | 14135 Ballantyne Corporate Pl Ste 200&160, Charlotte, NC 28277-3383 | 2016-01-04 |
| 1013350727 | Aileen Deng | Internal Medicine | 8401 University Exec Park Dr Ste 130, Charlotte, NC 28262-4358 | 2013-04-11 |
| 1578873808 | Carolinas Physicians Network Inc | Internal Medicine | 10826 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-7782 | 2010-10-20 |
| 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.