NOVANT MEDICAL GROUP, INC. (NPI# 1073179867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073179867 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
311 Coddle Market Dr Nw Ste 200 Concord NC 28027-2432 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165285 |
| Mailing Telephone | 8442668268 |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |
| Authorized Official Name | SHALA DAVIS (MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatric Endocrinology | 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 |
311 CODDLE MARKET DR NW STE 200 |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-2432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388967 | Novant Medical Group, Inc. | Neurological Surgery | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2020-08-26 |
| 1104479708 | Novant Medical Group Inc | Pediatrics | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2019-07-23 |
| 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 | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912334335 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 | 2013-09-30 |
| 1467558924 | Kecha Lynshue | Pediatrics | 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 | 2006-09-15 |
| 1912946922 | Cmc-northeast, Inc. | Pediatrics | 100 Medical Park Dr, Suite 310 - Northeast Pediatric Endocrinology, Concord, NC 28025-2966 | 2006-06-05 |
| 1538131776 | Thea Pfeifer | Pediatrics | 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124202114 | Jennifer Rachel Law | Pediatrics | 3341 Mbrb Cb 7039, University of North Carolina, Chapel Hill, NC 27599-0001 | 2007-12-26 |
| 1245443126 | Nina Jain | Pediatrics | Unc, Cb # 7039, 3341 Biomolecular (mbrb), Chapel Hill, NC 27599-0001 | 2007-05-08 |
| 1376696062 | Cmc-northeast, Inc | Pediatrics | 16623 Birkdale Cmns Pkwy, Suite 110, Ne Pediatric Endo, Huntersville, NC 28078-5621 | 2007-01-18 |
| 1801825914 | Lisa Houchin | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-07-01 |
| 1437141611 | Maria Janae Henwood-finley | Pediatrics | 2150 Herbert Ct, Ecu Pediatric Specialty Clinic, Greenville, NC 27834-3736 | 2005-08-16 |
| 1265097695 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1386164051 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-23 |
| 1518378553 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2014-05-13 |
| 1902233380 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 9625 Northcross Center Ct, Ste 102c, Huntersville, NC 28078-7348 | 2013-10-01 |
| 1700213113 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 101 E Wt Harris Blvd, Bldg 3000 Ste 3301c, Charlotte, NC 28262-3485 | 2013-09-30 |
| Find all providers with the same taxonomy | ||||
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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.