NOVANT MEDICAL GROUP, INC. (NPI# 1184267007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184267007 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH MEMORY CARE |
| Practice Address |
6324 Fairview Rd Ste 310 Charlotte NC 28210-4172 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9803028680 |
| Practice Fax Number | 9803028681 |
| Mailing Telephone | 9803028680 |
| Mailing Fax Number | 9803028681 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-12-06 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Memory Care | 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 |
6324 FAIRVIEW RD STE 310 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-4172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184609752 | Tammy Lynne Johnson-wait | Registered Nurse | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2005-12-07 |
| 1174169593 | Novant Medical Group, Inc. | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2019-11-20 |
| 1841773892 | The Presbyterian Hospital | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2018-09-14 |
| 1649762451 | Tarra Marsh Boyd | Nurse Practitioner | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2018-06-06 |
| 1063618312 | Asaad Elsayed Ahmed | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2007-06-25 |
| 1235248246 | Mark Anthony Pippenger | Psychiatry & Neurology | 6324 Fairview Rd Ste 310, Charlotte, NC 28210 | 2006-08-30 |
| 1194832691 | Violeta Mihailescu | Internal Medicine | 6324 Fairview Rd Ste 310, Charlotte, NC 28210-4172 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578056057 | Novant Medical Group, Inc. | Psychiatry & Neurology | 15033 Ballancroft Pkwy Ste 200, Charlotte, NC 28277-4944 | 2018-06-11 |
| 1477992063 | Neil Ghanshyam Patel | Psychiatry & Neurology | 2801 Randolph Rd Ste 101, Charlotte, NC 28211-1051 | 2013-06-18 |
| 1437444346 | Megan Tudor Donnelly | Psychiatry & Neurology | 2801 Randolph Road Suite 101, Charlotte, NC 28211 | 2011-06-20 |
| 1992983589 | Sheela Myers | Psychiatry & Neurology | 10660 Park Road, Suite 4400, Charlotte, NC 28210 | 2008-02-05 |
| 1720161011 | Michael M Amiri | Psychiatry & Neurology | 1300 Baxter St Ste 114, Charlotte, NC 28204-3806 | 2006-10-23 |
| 1144321373 | Henry Joseph Horacek Jr. | Psychiatry & Neurology | 10716 Carmel Commons Blvd, Suite 120, Charlotte, NC 28226-3783 | 2006-09-26 |
| 1659322691 | Mohammad R. Bolouri | Psychiatry & Neurology | 7809 Sardis Rd, Charlotte, NC 28270-2757 | 2006-05-15 |
| 1013968858 | Richard David Jacobson | Psychiatry & Neurology | 4228 Brookfield Dr, Charlotte, NC 28210 | 2006-05-15 |
| 1306896592 | Kenneth Todd Ashkin | Psychiatry & Neurology | 8045 Providence Rd Ste 200, Charlotte, NC 28277-9724 | 2006-05-11 |
| 1336199587 | Thor Erik Borresen | Psychiatry & Neurology | 1900 Scott Ave, Charlotte, NC 28203-6046 | 2006-05-10 |
| 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.