NOVANT MEDICAL GROUP, INC. (NPI# 1265088280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265088280 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
3515 W Market St Ste 300 Greensboro NC 27403-4442 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043166493 |
| Practice Fax Number | 7043169859 |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-08-15 |
| Authorized Official Name | SHALA DAVIS (ENROLLMENT MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | Y |
| Parent Organization Name | NOVANT MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Breast Surgery | 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 |
3515 W MARKET ST STE 300 |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27403-4442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942317052 | Judy A Tjoe | Surgery | 3515 W Market St Ste 300, Greensboro, NC 27403-4442 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518581412 | Tina Tate | Nurse Practitioner | Behavioral Health Hospital, 700 Walter Reed Drive, Greensboro, NC 27403 | 2020-06-05 |
| 1609438514 | Gail Corneau | Psychologist | Uncg Psychology Clinic, 1100 West Market Street, Greensboro, NC 27403 | 2019-07-01 |
| 1528527298 | Kendall Austin Macdonald | Hearing Instrument Specialist | 2823 A Spring Garden St, Suite A, Greensboro, NC 27403 | 2019-03-13 |
| 1093292237 | Andrew Robertson | Pharmacist | 1903 W. Florida St, Greensboro, NC 27403 | 2018-07-20 |
| 1447778071 | Bac Developmental Program Inc | Day Training, Developmentally Disabled Services | 2203 Coliseum Blvd, Greensboro, NC 27403 | 2017-09-04 |
| 1144607128 | Waldo's Optical | Eyewear Supplier (Equipment, not the service) | 2500 Spring Garden St., Suite C, Greensboro, NC 27403 | 2015-04-29 |
| 1851703144 | Tedra Slade | Social Worker | 612 Pasteur Dr., Suite 300, Greensboro, NC 27403 | 2014-05-21 |
| 1336568807 | Brian Sninsky | Urology | Alliance Urology Specialists, Pa, 509 N. Elam Ave., 2nd Floor, Greensboro, NC 27403 | 2014-04-14 |
| 1003237785 | Peter Reich | Counselor | 907 Englewood St, Greensboro, NC 27403 | 2013-12-23 |
| 1508295429 | Alexander Wilson Lpc Inc | Counselor | 3719 West Market Street, Suite B, Greensboro, NC 27403 | 2013-11-01 |
| Find all providers in zip 27403 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336795137 | Novant Medical Group, Inc. | Surgery | 3515 W Market St Ste 310, Greensboro, NC 27403-4438 | 2019-08-16 |
| 1558701086 | Christopher Shane Mcdaniel | Surgery | 2516 Oakcrest Ave Ste B, Greensboro, NC 27408-1933 | 2013-06-28 |
| 1992045637 | George Rigo Brahn | Surgery | 1241 Big Water Cir, Greensboro, GA 30642-3715 | 2013-02-17 |
| 1528280898 | Alicia C Thomas | Surgery | 1002 N. Church St, Suite 302, Greensboro, NC 27401-1449 | 2007-05-03 |
| 1306927850 | Harrill Christopher Coley | Surgery | 3903 N Elm St, Suite 102, Greensboro, NC 27455-2594 | 2006-10-18 |
| 1942317052 | Judy A Tjoe | Surgery | 3515 W Market St Ste 300, Greensboro, NC 27403-4442 | 2006-08-24 |
| 1063443695 | Roy Marc Arkin | Surgery | 613 Woodvale Dr., Greensboro, NC 27410 | 2006-07-05 |
| 1508802778 | Harold A Nichols | Surgery | 509d N Elam Ave, North Elam Medical Plaza, Greensboro, NC 27403-1118 | 2006-06-22 |
| 1649213950 | James Hanley Morgan IIi | Surgery | 1002 N Church St Ste 302, Greensboro, NC 27401-1449 | 2006-06-14 |
| 1811954894 | Elizabeth Ann Wanek | Surgery | 6 N Pointe Ct, Greensboro, NC 27408-3187 | 2006-04-26 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27403 |
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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.