NOVANT MEDICAL GROUP, INC (NPI# 1376046581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376046581 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH BRAIN AND SPINE SURGERY |
| Practice Address |
10305 Hamptons Park Dr Ste 101 Huntersville NC 28078-7217 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043163070 |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-14 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Brain and Spine 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 |
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 |
| 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 |
| 1285882688 | Novant Medical Group, Inc. | Psychiatry & Neurology | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2008-08-28 |
| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144699620 | Carolina Neurosurgery & Spine Associates, Pa | Neurological Surgery | 9735 Kincey Ave, Suite 300, Huntersville, NC 28078-9118 | 2015-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104472125 | Novant Medical Group, Inc. | Neurological Surgery | 3515 W Market St Ste 210, Greensboro, NC 27403-4442 | 2019-08-15 |
| 1811492069 | Unc Rockingham Health Care, Inc. | Neurological Surgery | 518 S Van Buren Rd Ste 6, Eden, NC 27288-5017 | 2018-03-29 |
| 1538616289 | Private Diagnostic Clinic, Pllc | Neurological Surgery | 1212 Cedarhurst Dr Ste 102, Raleigh, NC 27609-5588 | 2016-09-09 |
| 1306228028 | Charles Rawlings IIi | Neurological Surgery | 426 Old Salem Rd, Winston Salem, NC 27101-5268 | 2015-06-19 |
| 1790048593 | Edward Yap | Neurological Surgery | 170 Manning Dr, Cb# 7060, Department of Neurosurgery, Chapel Hill, NC 27599-7060 | 2012-06-18 |
| 1588921969 | Thomas Ostergard | Neurological Surgery | 1130 N Church St Ste 200, Greensboro, NC 27401-1041 | 2012-04-23 |
| 1679898548 | Andrew Hall Marky | Neurological Surgery | 7825 Ballantyne Commons Pkwy Ste 150, Charlotte, NC 28277-3175 | 2010-04-02 |
| 1114256468 | William Leonard Sims | Neurological Surgery | 955 37th Ave Ne, Hickory, NC 28601-9609 | 2009-12-16 |
| 1497080006 | Novant Medical Group Inc | Neurological Surgery | 190 Kimel Park Dr Ste 155, Winston Salem, NC 27103-6946 | 2009-10-15 |
| 1205068186 | Jeffrey S Beecher | Neurological Surgery | 2208 S 17th St Ste 201, Wilmington, NC 28401-7594 | 2009-08-11 |
| 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.