NOVANT MEDICAL GROUP, INC. (NPI# 1437665361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437665361 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH SPORTS & PERFORMANCE MEDICINE |
| Practice Address |
8035 Providence Rd Ste 100 Charlotte NC 28277-9716 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043161222 |
| Practice Fax Number | 7043161223 |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-14 |
| 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 | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Sports & Performance Medicine | 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 |
8035 PROVIDENCE RD STE 100 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-9716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487047874 | Lax Group LLC | Pharmacy | 8035 Providence Rd Ste 100, Charlotte, NC 28277-9716 | 2015-03-10 |
| 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 | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154813756 | Willie Phillips II | Physical Medicine & Rehabilitation | 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2018-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679130744 | Mojo Sportclinic, LLC | Physical Medicine & Rehabilitation | 6859 Monument Dr, Wilmington, NC 28405-4178 | 2019-05-23 |
| 1679138176 | Jeneva Gatses | Physical Medicine & Rehabilitation | 13759 Cinnabar Pl, Huntersville, NC 28078-5342 | 2019-05-09 |
| 1285159905 | Austin John Hille | Physical Medicine & Rehabilitation | 400 Landis Ct. #203, Asheville, NC 28806 | 2017-08-03 |
| 1174052138 | Olivia Sabo | Physical Medicine & Rehabilitation | 8814 Red Rd, Rockwell, NC 28138-6500 | 2017-06-05 |
| 1770180903 | Kenneth Lassiter | Physical Medicine & Rehabilitation | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2020-10-01 |
| 1588296719 | Douglas Maccallum | Physical Medicine & Rehabilitation | 2121 E Williams St Ste 108, Apex, NC 27539-7765 | 2020-02-05 |
| 1972153419 | Meredith Elise Bland | Physical Medicine & Rehabilitation | 3475 Erwin Rd, Durham, NC 27705-0005 | 2019-09-17 |
| 1275188484 | Edward Albert Marshall Jr. | Physical Medicine & Rehabilitation | 224 East Wilson Street, Wingate, NC 28174 | 2019-08-05 |
| 1881174878 | Jaela Marie Wilson | Physical Medicine & Rehabilitation | 1801 Fayetteville St, Durham, NC 27707-3129 | 2018-08-19 |
| 1841784170 | Jordan Drew Bettleyon | Physical Medicine & Rehabilitation | 5400 Ramsey St, Fayetteville, NC 28311 | 2018-06-20 |
| Find all providers with the same taxonomy | ||||
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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.