NOVANT MEDICAL GROUP, INC (NPI# 1316245475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316245475 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | PRESBYTERIAN BARIATRIC&GENERAL SURGERY |
| Practice Address |
15825 John J Delaney Dr Suite 220 Charlotte NC 28277-3147 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043167740 |
| Practice Fax Number | 7043167745 |
| Mailing Telephone | 7043167740 |
| Mailing Fax Number | 7043167745 |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2013-07-05 |
| Authorized Official Name | MR. GEOFFREY GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043849094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RB0002X |
Internal Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5917054 | 05 |
| Other Name | Type Code |
|---|---|
| Presbyterian Bariatric&General Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
| 1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 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 |
15825 JOHN J DELANEY DR SUITE 220 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-3147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366444119 | Robert Mcdonald | Internal Medicine | 15825 John J Delaney Dr, Suite 200, Charlotte, NC 28277-3146 | 2005-08-11 |
| 1841444361 | Novant Medical Group, Inc. | Internal Medicine | 15825 John J Delaney Dr, Suite 260, Charlotte, NC 28277-3146 | 2008-11-11 |
| 1063665263 | Orthocarolina | Physical Therapist | 15825 John J Delaney Dr, Suite 140, Charlotte, NC 28277-3146 | 2008-10-31 |
| 1518140771 | Nanci S Weil | Occupational Therapist | 15825 John J Delaney Dr, Charlotte, NC 28277-3146 | 2007-12-11 |
| 1801076260 | Kathyrn D. Jendrasik-savitsky, Dmd, Pa | Clinic/Center | 15825 John J Delaney Dr, Suite 150, Charlotte, NC 28277-3146 | 2007-11-13 |
| 1134262389 | Veronica I Shafer | Physical Therapist | 15825 John J Delaney Dr, Suite 100, Charlotte, NC 28277-3146 | 2007-02-15 |
| 1083763551 | Kathryn Dawn Jendrasik Savitsky | Dentist | 15825 John J Delaney Dr, Suite 150, Charlotte, NC 28277-3146 | 2007-01-10 |
| 1720160856 | Doris Elisabeth Wiese | Physical Therapist | 15825 John J Delaney Dr, Charlotte, NC 28277-3146 | 2006-10-19 |
| 1649380288 | Todd R Shropshire | Physical Therapist | 15825 John J Delaney Dr, Suite 120, Charlotte, NC 28277-3146 | 2006-08-30 |
| 1508889643 | Robert Pasquale Raspa | Physician Assistant | 15825 John J Delaney Dr, Suite 100, Charlotte, NC 28277-3146 | 2006-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| 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 |
|---|---|---|---|---|
| 1922645571 | Novant Medical Group, Inc. | Surgery | 6324 Fairview Rd Ste 420, Charlotte, NC 28210-3372 | 2019-12-03 |
| 1154806271 | The Cosmetic Concierge, Pllc | Surgery | 325 Arlington Ave Unit B, Charlotte, NC 28203-4574 | 2018-09-25 |
| 1619363538 | William Charles Sherrill IIi | Surgery | 1000 Blythe Blvd Ste 601, Charlotte, NC 28203-5812 | 2015-04-07 |
| 1174968069 | Jonathan Bouchez | Surgery | 1000 Blythe Bvld., Charlotte, NC 28203 | 2013-05-06 |
| 1437475779 | Blair A Wormer | Surgery | 1901 Brunswick Ave Ste 200, Charlotte, NC 28207-1897 | 2010-04-12 |
| 1407039845 | Charles Arthur Hill IIi | Surgery | 325 Hawthorne Ln Ste 100, Charlotte, NC 28204 | 2007-12-07 |
| 1841491370 | Johnnie Lyles | Surgery | 2908 Oak Lake Blvd, Suite 205, Charlotte, NC 28208-7703 | 2007-05-31 |
| 1619000486 | Gordon W Jacobs | Surgery | 14920 Wyndham Oaks Dr, Charlotte, NC 28277-1512 | 2007-03-13 |
| 1750421228 | Sandra Giller | Surgery | 1918 Randolph Rd Ste 130, Charlotte, NC 28207-1107 | 2007-02-07 |
| 1831255009 | Wendell Aubrey Goins | Surgery | 9336 Blakeney Centre Dr, Ste 100b, Charlotte, NC 28277-6666 | 2006-12-29 |
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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.