NOVANT MEDICAL GROUP, INC. (NPI# 1356988778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356988778 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
6324 Fairview Rd Ste 400 Charlotte NC 28210-4278 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9803028642 |
| Practice Fax Number | 9803028657 |
| Mailing Telephone | 9803028642 |
| Mailing Fax Number | 9803028657 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |
| 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 |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pulmonary & Critical 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 400 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-4278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578706685 | Sandy Charles | Internal Medicine | 6324 Fairview Rd Ste 400, Charlotte, NC 28210-4278 | 2009-04-20 |
| 1720687593 | Nicole R Freeman | Nurse Practitioner | 6324 Fairview Rd Ste 400, Charlotte, NC 28210-4278 | 2020-10-22 |
| 1679110621 | Novant Medical Group, Inc. | Psychiatry & Neurology | 6324 Fairview Rd Ste 400, Charlotte, NC 28210-4278 | 2019-12-09 |
| 1083251300 | Novant Medical Group, Inc. | Internal Medicine | 6324 Fairview Rd Ste 400, Charlotte, NC 28210-4278 | 2019-12-05 |
| 1457904575 | Melissa Rohrer Tungare | Nurse Practitioner | 6324 Fairview Rd Ste 400, Charlotte, NC 28210-4278 | 2019-07-17 |
| 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 | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1740200047 | James B Jones | Internal Medicine | 6060 Piedmont Row Dr S Fl 10, Charlotte, NC 28287 | 2006-07-20 |
| 1962470666 | Estrelita Nancy Clavio-ziechmann | Internal Medicine | 10036 Park Cedar Dr, Suite A, Charlotte, NC 28210-8914 | 2006-03-09 |
| 1780974816 | Sailaja Allamneni | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2011-04-11 |
| 1669779583 | Anil Jotwani | Internal Medicine | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2011-02-14 |
| 1649590324 | Joshua Davis | Internal Medicine | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2010-06-04 |
| 1619293701 | John Wynne | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2010-04-14 |
| 1083843304 | Muhammad Rashad | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2009-07-08 |
| 1962658856 | Alfred Papali | Internal Medicine | 10650 Park Rd, Ste 300, Charlotte, NC 28210-8538 | 2008-08-12 |
| 1235390691 | Joshua Smith | Internal Medicine | 1001 Blythe Blvd, Charlotte, NC 28203-5866 | 2008-06-18 |
| 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.