NOVANT MEDICAL GROUP, INC. (NPI# 1568027001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568027001 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Practice Address |
201 Queens Rd Charlotte NC 28204-3217 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043849679 |
| Mailing Telephone | 8442668268 |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |
| Authorized Official Name | SHALA DAVIS (MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatric Nephrology | 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 |
201 QUEENS RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083663454 | Larry Jason Byrd | Nurse Practitioner | 201 Queens Rd, Charlotte, NC 28204-3217 | 2006-05-10 |
| 1134765126 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-11-25 |
| 1093376642 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-06-25 |
| 1417433947 | Shelly Spoerre | Dietitian, Registered | 201 Queens Rd, Charlotte, NC 28204-3217 | 2018-07-18 |
| 1205320306 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204 | 2018-06-21 |
| 1639695133 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204 | 2017-08-16 |
| 1417477977 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-26 |
| 1386164051 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-23 |
| 1386173581 | Jonathan Mercer Foell | Specialist/Technologist | 201 Queens Rd, Charlotte, NC 28204 | 2017-06-09 |
| 1295278471 | Christina Simpson | Nurse Practitioner | 201 Queens Rd, Charlotte, NC 28204-3217 | 2016-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548671902 | Hailey Gavigan | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2014-05-19 |
| 1386851491 | Donald Weaver Jr. | Pediatrics | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2007-05-17 |
| 1154335180 | Susan Massengill | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2006-07-27 |
| 1629092895 | Charles Mckay | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013234335 | Katherine Davis Westreich | Pediatrics | 7024 Burnett Womack Bldg Cb 7155, Unc Kidney Center, Chapel Hill, NC 27599-7155 | 2010-04-26 |
| 1063051340 | Novant Medical Group, Inc. | Pediatrics | 1401 Matthews Township Pkwy Ste 100, Matthews, NC 28105-5403 | 2020-01-03 |
| 1972923753 | Kiri Wiggins Bagley | Pediatrics | 101 Manning Dr, North Carolina Children's Hospital, Chapel Hill, NC 27514-4220 | 2014-04-21 |
| 1649618380 | Hostensia Mbi Beng | Pediatrics | 2150 Herbert Ct, Greenville, NC 27834-3736 | 2013-06-04 |
| 1104184464 | Liliana Michelle Gomez Mendez | Pediatrics | 2150 Herbert Ct, Greenville, NC 27834 | 2012-04-24 |
| 1093944407 | Keia R Sanderson | Pediatrics | 7024 Burnett Womack, Cb 7155, Chapel Hill, NC 27599-4619 | 2009-07-07 |
| 1215128459 | Ashton Chen | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-08-05 |
| 1952437501 | Eileen Tsai Chambers | Pediatrics | 2301 Erwin Rd, Durham, NC 27705-4699 | 2007-02-26 |
| 1922161793 | John Foreman | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| 1194757633 | Jen-jar Lin | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-07-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NOVANT MEDICAL GROUP, INC..
| 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.