NOVANT MEDICAL GROUP INC (NPI# 1164987616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164987616 |
Entity Type | Organization |
Organization Name | NOVANT MEDICAL GROUP INC |
Other Organization Name | NOVANT HEALTH PEDIATRIC NEUROLOGY |
Practice Address |
311 Coddle Market Dr Nw Ste 200 Concord NC 28027-2432 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 7043841390 |
Practice Fax Number | 7043841063 |
Enumeration Date | 2019-02-08 |
Last Update Date | 2019-03-18 |
Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
Authorized Official Telephone | 7043167845 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Novant Health Pediatric Neurology | 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 |
---|---|---|---|---|
1801866355 | Tara G Gaines | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027 | 2006-01-26 |
1689139693 | Novant Medical Group, Inc. | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027-2432 | 2019-02-04 |
1154397016 | Kymberly F Selden | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027-2432 | 2006-02-28 |
1548236680 | Stephen Lods | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027-2432 | 2006-02-28 |
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 | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396172516 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2013-10-02 |
1457520918 | Robet L Sieben, Md, Inc | Psychiatry & Neurology | 3301 Clayton Rd, Concord, CA 94519-2820 | 2008-02-28 |
1962629139 | Georgi Brockway | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2007-04-19 |
1427177112 | Robert Leonard Sieben | Psychiatry & Neurology | 2425 East St, Suite 10, Concord, CA 94520-1928 | 2007-03-27 |
1093751471 | Timothy Scott Livingston | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2966 | 2006-06-22 |
1730135047 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2006-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
1740547496 | Dmitry Tchapyjnikov | Psychiatry & Neurology | Dept of Pediatrics Duke University Medical Ctr, 2301 Erwin Rd., Children's Health Center, Duke Universi, Durham, NC 27710-0001 | 2012-04-19 |
1043525280 | Cmc-northeast, Inc. | Psychiatry & Neurology | 6600 Wilkinson Blvd, Carolinas Pediatric Neurology Care - Holy Angels, Belmont, NC 28012-2796 | 2010-08-12 |
1750610689 | Virinder Nohria | Psychiatry & Neurology | 111 Skyline View Rd, Franklin, NC 28734-4769 | 2009-12-24 |
1144463993 | Monica Elizabeth Lemmon | Psychiatry & Neurology | Dumc 3936, Durham, NC 27710-6667 | 2009-04-09 |
1245431600 | Yael Shiloh-malawsky | Psychiatry & Neurology | 170 Manning Dr., Department of Neurology Cb#7025, Chapel Hill, NC 27514-4220 | 2007-05-31 |
1598795635 | Kadry R Allaboun | Psychiatry & Neurology | 115 Foothills Dr, Morganton, NC 28655-5152 | 2006-07-04 |
1962473033 | David Jay Jaffe | Psychiatry & Neurology | 508 Sandhurst Dr, A, Fayetteville, NC 28304-4434 | 2006-01-27 |
1558368936 | Susan B Boutilier | Psychiatry & Neurology | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2005-06-30 |
1437629664 | Mission Community Anesthesiology Specialists LLC | Psychiatry & Neurology | 890 Hendersonville Rd Ste 200, Asheville, NC 28803-2997 | 2018-11-30 |
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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.