NOVANT MEDICAL GROUP INC (NPI# 1104479708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104479708 |
| 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 | 9803029145 |
| Practice Fax Number | 7043840568 |
| Mailing Telephone | 9803029145 |
| Mailing Fax Number | 7043840568 |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |
| Authorized Official Name | SHALA DAVIS (MANAGED CARE ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Developmental &Behavioral Pediatrics | 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 |
311 CODDLE MARKET DR NW STE 200 |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-2432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073179867 | Novant Medical Group, Inc. | Pediatrics | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2019-05-16 |
| 1699388967 | Novant Medical Group, Inc. | Neurological Surgery | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2020-08-26 |
| 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 | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508080342 | Cynthia Anne Kahn | Pediatrics | 29 Hazen Dr, Concord, NH 03301-6503 | 2007-04-12 |
| 1033546403 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 301 Medical Park Dr, Ste 202b, Concord, NC 28025-2981 | 2013-10-01 |
| 1467694661 | Robert Nutt | Pediatrics | 301 Medical Park Dr, Suite 202b, Concord, NC 28025-2981 | 2009-04-02 |
| 1528011582 | Mark Clayton | Pediatrics | 301 Medical Park Dr, Ste 202b, Concord, NC 28025-2981 | 2006-05-18 |
| 1568424547 | Carolinas Medical Center-northeast | Pediatrics | 301 Medical Park Dr, Suite 202b, Concord, NC 28025-2981 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548746365 | Kassondra Amada Shoemaker Brino | Pediatrics | 307 S Salem St Ste 100, Apex, NC 27502-1845 | 2018-07-15 |
| 1164949814 | Moses Cone Physician Services, Inc. | Pediatrics | 301 E Wendover Ave Ste 311, Greensboro, NC 27401-1210 | 2017-08-24 |
| 1821474628 | Melissa Thingvoll Md Pllc | Pediatrics | 7 Yorkshire St Ste 101, Asheville, NC 28803-2798 | 2015-08-04 |
| 1053445130 | Barbara Nan Samuels | Pediatrics | 108 W Fire Tower Rd Ste B, Ecu Pediatrics Autism Center, Winterville, NC 28590-8408 | 2007-03-14 |
| 1396823498 | Patricia Dockery Weavil | Pediatrics | 4805 Seward Rd, Pfafftown, NC 27040-9450 | 2006-11-02 |
| 1780782805 | Jean Charlotte Smith | Pediatrics | 10 Sunnybrook Road, Wake County Human Services, Raleigh, NC 27610-1808 | 2006-09-20 |
| 1881689362 | Barbara Elizabeth Kissam | Pediatrics | 1900 Randolph Rd, Suite 1010, Charlotte, NC 28207-1122 | 2005-09-12 |
| 1528060209 | Arne John Anderson | Pediatrics | 108 W Fire Tower Rd, Winterville, NC 28590-8371 | 2005-08-12 |
| 1508426370 | Novant Medical Group Inc | Pediatrics | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2019-06-14 |
| 1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
| 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.