NOVANT MEDICAL GROUP INC (NPI# 1487020020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487020020 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP INC |
| Other Organization Name | NOVANT HEALTH BRAIN AND SPINE SURGERY |
| Practice Address |
330 Billingsley Rd Suite 202 Charlotte NC 28211-5055 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043163070 |
| Practice Fax Number | 7043163071 |
| Mailing Telephone | 7043163070 |
| Mailing Fax Number | 7043163071 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2017-10-18 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043163070 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Brain and Spine Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433711 | Novant Medical Group Inc | Psychiatry & Neurology | 933 Rockford St Ste 2, Mount Airy, NC 27030-5323 | 2019-08-23 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1205355799 | Novant Medical Group Inc | Family Medicine | 16525 Holly Crest Ln Ste 250, Huntersville, NC 28078-4912 | 2017-09-15 |
| 1679090468 | Novant Medical Group Inc | Internal Medicine | 12311 Copper Way Ste 100, Charlotte, NC 28277-3643 | 2017-08-23 |
| 1003332016 | Novant Medical Group Inc | Internal Medicine | 10030 Gilead Rd Ste 344, Huntersville, NC 28078-7545 | 2017-08-22 |
| 1255709432 | Novant Medical Group Inc | Family Medicine | 19485 Old Jetton Road, Suite 100, Cornelius, NC 28031-6583 | 2015-09-04 |
| 1215326665 | Novant Medical Group Inc | Surgery | 819 N Atlantic Ave, Southport, NC 28461-3531 | 2015-01-22 |
| 1194113662 | Novant Medical Group Inc | Obstetrics & Gynecology | 1730 Kernersville Medical Parkway, Suite 104, Kernersville, NC 27284-7198 | 2015-01-06 |
| 1437556594 | Novant Medical Group Inc | Internal Medicine | 13 Medical Campus, Suite 102, Supply, NC 28462-4093 | 2014-12-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Novant Medical Group Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Novant Medical Group Inc. | 2085 Frontis Plaza Blvd, Winston Salem, North Carolina 27103 |
| Street Address |
330 BILLINGSLEY RD SUITE 202 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-5055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801897160 | John Edwin Lacouture Jr. | Specialist | 330 Billingsley Rd, Suite 103, Charlotte, NC 28211-5055 | 2005-08-09 |
| 1386288199 | Ellen Anderson | Counselor | 330 Billingsley Rd, Charlotte, NC 28211-5055 | 2019-11-05 |
| 1689183568 | Linda Latasha Williams | Social Worker | 330 Billingsley Rd, Charlotte, NC 28211-5055 | 2017-09-24 |
| 1467900977 | Novant Medical Group, Inc | Internal Medicine | 330 Billingsley Rd, Suite 101, Charlotte, NC 28211-5020 | 2016-09-13 |
| 1659826295 | The Cataract Vision Institute LLC | Clinic/Center | 330 Billingsley Rd, Suite 205, Charlotte, NC 28211-5055 | 2016-08-24 |
| 1952792012 | Walton S. Peery,dds Pa | Dentist | 330 Billingsley Rd, Suite 200, Charlotte, NC 28211-5055 | 2015-02-11 |
| 1700129640 | Trina Health of The Carolinas | Clinic/Center | 330 Billingsley Rd, Suite 108, Charlotte, NC 28211-5055 | 2013-03-28 |
| 1780934224 | The Lasik Vision Institute, LLC | Clinic/Center | 330 Billingsley Rd, Ste 205, Charlotte, NC 28211-5055 | 2012-09-12 |
| 1730362104 | Mary Jorden Mcninch | Nurse Practitioner | 330 Billingsley Rd, Ste 101, Charlotte, NC 28211-5055 | 2007-12-09 |
| 1215130794 | David W. Stroup, Dds | Dentist | 330 Billingsley Rd, Charlotte, NC 28211-5055 | 2007-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| 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 |
|---|---|---|---|---|
| 1578056057 | Novant Medical Group, Inc. | Psychiatry & Neurology | 15033 Ballancroft Pkwy Ste 200, Charlotte, NC 28277-4944 | 2018-06-11 |
| 1477992063 | Neil Ghanshyam Patel | Psychiatry & Neurology | 2801 Randolph Rd Ste 101, Charlotte, NC 28211-1051 | 2013-06-18 |
| 1437444346 | Megan Tudor Donnelly | Psychiatry & Neurology | 2801 Randolph Road Suite 101, Charlotte, NC 28211 | 2011-06-20 |
| 1992983589 | Sheela Myers | Psychiatry & Neurology | 10660 Park Road, Suite 4400, Charlotte, NC 28210 | 2008-02-05 |
| 1720161011 | Michael M Amiri | Psychiatry & Neurology | 1300 Baxter St Ste 114, Charlotte, NC 28204-3806 | 2006-10-23 |
| 1144321373 | Henry Joseph Horacek Jr. | Psychiatry & Neurology | 10716 Carmel Commons Blvd, Suite 120, Charlotte, NC 28226-3783 | 2006-09-26 |
| 1659322691 | Mohammad R. Bolouri | Psychiatry & Neurology | 7809 Sardis Rd, Charlotte, NC 28270-2757 | 2006-05-15 |
| 1013968858 | Richard David Jacobson | Psychiatry & Neurology | 4228 Brookfield Dr, Charlotte, NC 28210 | 2006-05-15 |
| 1306896592 | Kenneth Todd Ashkin | Psychiatry & Neurology | 8045 Providence Rd Ste 200, Charlotte, NC 28277-9724 | 2006-05-11 |
| 1336199587 | Thor Erik Borresen | Psychiatry & Neurology | 1900 Scott Ave, Charlotte, NC 28203-6046 | 2006-05-10 |
| 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.