NOVANT MEDICAL GROUP, INC. (NPI# 1285882688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285882688 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH NEUROLOGY |
| Practice Address |
10305 Hamptons Park Dr Ste 101 Huntersville NC 28078-7217 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165388 |
| Practice Fax Number | 7043161848 |
| Mailing Telephone | 7043165388 |
| Mailing Fax Number | 7043161848 |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2017-12-07 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043849144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
NC | Allopathic & Osteopathic Physicians | |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Neurology | 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 |
10305 HAMPTONS PARK DR STE 101 |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-7217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548269962 | Edward Conrad Robles | Physical Medicine & Rehabilitation | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2005-07-18 |
| 1528541026 | Chelsey Sisko | Physician Assistant | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2018-09-11 |
| 1316426398 | Noant Medical Group, Inc | Physical Medicine & Rehabilitation | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2018-08-09 |
| 1629563671 | Anastasia V. Slisenko | Nurse Practitioner | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078 | 2018-06-22 |
| 1376046581 | Novant Medical Group, Inc | Neurological Surgery | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2018-03-14 |
| 1215454053 | Novant Medical Group, Inc | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2017-08-23 |
| 1104222785 | Ansley Walker Boutin | Physical Therapist | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2014-11-10 |
| 1790893006 | James W. Forrest | Physician Assistant | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2006-08-27 |
| 1578676979 | Charles Andrew Little | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078 | 2006-08-17 |
| 1295759983 | Michael Christopher Ficenec | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7221 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787718 | John M. Bakarich, Dds, Pllc | Dentist | 15810 Northcross Drive, Suite A, Huntersville, NC 28078 | 2020-07-14 |
| 1316587082 | Blake Allen Klessig | Chiropractor | 8936 Northpointe Executive Park Dr, Suite 195, Huntersville, NC 28078 | 2020-01-10 |
| 1922644830 | Steven James Underwood | Physical Therapist | Aldersgate Ccrc, 3800 Shamrock Drive, Charlotte, NC 28078 | 2019-11-26 |
| 1851856306 | Jessica Runnion | Behavior Technician | 14625 Reese Blvd, Apartment 208, Huntersville, NC 28078 | 2019-02-08 |
| 1568935401 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 111 Commerce Centre Drive, Suite 305, Huntersville, NC 28078 | 2019-01-03 |
| 1932691763 | Shakira Grier | Massage Therapist | 15905 Brookway Drive, Ste 4202, Huntersville, NC 28078 | 2018-06-06 |
| 1457850596 | Chudney Drew | Counselor | 10224 Hickorywood Hill Ave Ste 201, Huntersville, NC 28078 | 2018-02-05 |
| 1215457122 | Amy Nicole Castongia | Counselor | 10511 Drake Hill Dr, Huntersville, NC 28078 | 2017-06-21 |
| 1457714057 | Robin D Disbro | Registered Nurse | 6216 Colonial Garden Drive, Huntersville, NC 28078 | 2016-03-31 |
| 1144695545 | Huntersville H&r Ops Limited Partnership | Skilled Nursing Facility | 13835 Boren Street, Huntersville, NC 28078 | 2015-12-10 |
| Find all providers in zip 28078 | ||||
| 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 |
|---|---|---|---|---|
| 1952657363 | Roderick Elias | Psychiatry & Neurology | 9735 Kincey Ave Ste 203, Huntersville, NC 28078-9120 | 2012-08-03 |
| 1811100142 | Peterson F Giallanza | Psychiatry & Neurology | 403 Gilead Rd, Suite B, Huntersville, NC 28078-6813 | 2007-05-07 |
| 1073998787 | Novant Medical Group, Inc | Psychiatry & Neurology | 6909 Prosperity Church Rd, Huntersville, NC 28078-6698 | 2015-07-23 |
| 1225465362 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 9625 Northcross Center Ct, Suite 102b, Huntersville, NC 28078-7348 | 2013-10-03 |
| 1629405212 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 9625 Northcross Center Ct, Ste 102, Huntersville, NC 28078-7348 | 2013-09-27 |
| 1821248196 | Novant Medical Group, Inc. | Psychiatry & Neurology | 16525 Holly Crest Ln, Suite 120, Huntersville, NC 28078-4909 | 2008-09-24 |
| 1700075702 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 9625 Northcross Center Ct, Suite 102-f, Huntersville, NC 28078-7348 | 2007-10-16 |
| 1609862283 | Ki Soo Jung | Psychiatry & Neurology | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574706 | Nandigam Neurology, LLC | Psychiatry & Neurology | 10 Doctors Cir Ste 1, Supply, NC 28462-4218 | 2020-09-30 |
| 1033738299 | Catawba Valley Medical Group Inc | Psychiatry & Neurology | 3246 6th Ave Se Ste 101, Hickory, NC 28602-8335 | 2020-04-08 |
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1952886582 | John Messenheimer | Psychiatry & Neurology | 55 Hermitage Ln, Moncure, NC 27559-9670 | 2018-09-28 |
| 1578056057 | Novant Medical Group, Inc. | Psychiatry & Neurology | 15033 Ballancroft Pkwy Ste 200, Charlotte, NC 28277-4944 | 2018-06-11 |
| 1619474012 | Jamie Hannah Rose Aldridge | Psychiatry & Neurology | 1121 N Church Street, Greensboro, NC 27401 | 2018-04-11 |
| 1811417835 | Arvind Muralimohan Gomadam | Psychiatry & Neurology | 1492 Rymco Dr, Winston Salem, NC 27103 | 2017-06-21 |
| 1932637568 | Irena Dujmovic Basuroski | Psychiatry & Neurology | 194 Finley Golf Course Road, Suite 200, Chapel Hill, NC 27517 | 2017-05-26 |
| 1750838702 | Zuleyma Enid Toledo-nieves | Psychiatry & Neurology | Unc Hospitals Department of Neurology, 170 Manning Drive, Cb#7025, Chapel Hill, NC 27599-7025 | 2016-09-07 |
| 1659722593 | Arfeen Geriatric Care Pllc | Psychiatry & Neurology | 2961 Crouse Ln Ste D, Burlington, NC 27215-8833 | 2016-06-22 |
| Find all providers with the same taxonomy | ||||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
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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.