NOVANT MEDICAL GROUP, INC. (NPI# 1659936011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659936011 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH CANCER INSTITUTE |
| Practice Address |
5701 W Friendly Ave Greensboro NC 27410-4112 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3365644170 |
| Practice Fax Number | 3365644936 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | SHALA DAVIS (RCS MANAGER) |
| Authorized Official Telephone | 7043167845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Cancer Institute | Doing Business As Name - Organization |
| Novant Health Oncology Specialists | 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 |
5701 W FRIENDLY AVE |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27410-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689989634 | Sherry A Royster | Counselor | 5701 W Friendly Ave, Greensboro, NC 27410 | 2010-08-15 |
| 1487130316 | Noant Medical Group, Inc | Surgery | 5701 W Friendly Ave, Greensboro, NC 27410-4112 | 2018-07-13 |
| 1932659901 | Novant Medical Group, Inc | Internal Medicine | 5701 W Friendly Ave, Greensboro, NC 27410-4112 | 2016-10-13 |
| 1932570520 | Peter Snow | Nurse Practitioner | 5701 W Friendly Ave, Greensboro, NC 27410-4112 | 2015-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669095014 | Well-spring Home Care LLC | In Home Supportive Care | 3859 Battleground Avenue, Suite 301, Greensboro, NC 27410 | 2020-05-20 |
| 1679139372 | Iora Health North Carolina, P.C. | Internal Medicine | 3351 Battleground Ave., Greensboro, NC 27410 | 2019-05-17 |
| 1669950689 | Matthew W Devaney Dds @ Brassfield, Pa | Dentist | 2018 New Garden Rd D., Greensboro, NC 27410 | 2018-08-01 |
| 1306323951 | Carolina Children's Eye Care, Pa | Ophthalmology | Friendly-holden Building, 3608 W Friendly Ave, Suite 101, Greensboro, NC 27410 | 2018-07-26 |
| 1457846495 | Courtney Canty James | Pharmacist | 3300 W Friendly Ave, Greensboro, NC 27410 | 2018-06-22 |
| 1063904506 | Jonathan Hunt | Dentist | 5506 W Friendly Ave Ste 101, Greensboro, NC 27410 | 2018-05-31 |
| 1487158549 | Ruth Ann Foster | Registered Nurse | 3005 Steepleton Colony Court, Greensboro, NC 27410 | 2018-03-22 |
| 1568973360 | Novant Medical Group Inc. | Internal Medicine | 1622 Highwoods Blvd Unit G105, Greensboro, NC 27410 | 2017-10-19 |
| 1942724729 | Greenbrook Tms Greensboro LLC | Psychiatry & Neurology | 1931 New Garden Rd Ste 108, Greensboro, NC 27410 | 2017-08-02 |
| 1750810156 | Ibrahim Koroma | Home Health Aide | 4907 Hickory Woods Dr, Greensboro, NC 27410 | 2017-06-08 |
| Find all providers in zip 27410 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982680120 | Maureen Adele Jarrell | Obstetrics & Gynecology | 1908 Lendew St, Greensboro, NC 27408-7007 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245596907 | Ama Buskwofie | Obstetrics & Gynecology | 215 William Penn Plz Apt 735, Durham, NC 27704-2555 | 2012-04-06 |
| 1184704264 | Wendy R. Brewster | Obstetrics & Gynecology | 3027 Old Clinic Bldg., Cb #7570, Dept. of Ob/gyn, Chapel Hill, NC 27599-7570 | 2006-10-16 |
| 1902846330 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2006-06-07 |
| 1508857962 | Michael John Sundborg | Obstetrics & Gynecology | 145 Applecross Rd, Southern Pines, NC 28388-0749 | 2005-11-03 |
| 1477171759 | The Presbyterian Hospital | Obstetrics & Gynecology | 125 Queens Rd Ste 540, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1295385748 | Mcpc-20, LLC | Obstetrics & Gynecology | 220 Page Rd, Pinehurst, NC 28374-8748 | 2019-09-17 |
| 1093369530 | Novant Medical Group. Inc. | Obstetrics & Gynecology | 2290 Remount Rd, Gastonia, NC 28054-4725 | 2019-08-01 |
| 1386206951 | Rex Hospital Inc | Obstetrics & Gynecology | 4420 Lake Boone Trl Ste 201, Raleigh, NC 27607-7505 | 2019-07-03 |
| 1194138925 | Lindsey Buckingham | Obstetrics & Gynecology | 101 Manning Dr, Chapel Hill, NC 27514-4220 | 2014-06-10 |
| 1063859726 | Stuart-allison Moffat Staley | Obstetrics & Gynecology | 101 Manning Dr, Department of Ob/gyn, Chapel Hill, NC 27514-4220 | 2013-06-04 |
| Find all providers with the same taxonomy | ||||
| City | GREENSBORO |
| Zip Code | 27410 |
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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.