NOVANT MEDICAL GROUP, INC. (NPI# 1689139693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689139693 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH PEDIATRICS CONCORD |
| Practice Address |
311 Coddle Market Dr Nw Ste 100 Concord NC 28027-2432 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9803029100 |
| Mailing Telephone | 8442668268 |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-03-11 |
| 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 | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatrics Concord | 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 |
311 CODDLE MARKET DR NW STE 100 |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-2432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866355 | Tara G Gaines | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027 | 2006-01-26 |
| 1164987616 | Novant Medical Group Inc | Psychiatry & Neurology | 311 Coddle Market Dr Nw, Ste 200, Concord, NC 28027-2432 | 2019-02-08 |
| 1154397016 | Kymberly F Selden | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027-2432 | 2006-02-28 |
| 1548236680 | Stephen Lods | Pediatrics | 311 Coddle Market Dr Nw, Ste 100, Concord, NC 28027-2432 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023652252 | Medcare Transport of Nc | Non-emergency Medical Transport (VAN) | 7039 Northwinds Dr Nw, Unit C, Concord, NC 28027 | 2019-10-31 |
| 1538718770 | Carolyn Ann Broadnax | Technician | 3524 Cedar Springs Dr, Concord, NC 28027 | 2019-09-10 |
| 1447806575 | Claire-ann E Papp | Dentist | 8815 Christenbury Parkway, Suite 40, Concord, NC 28027 | 2019-08-14 |
| 1578120218 | Philip Osborn | Dentist | 5408 Nc-49, Harrisburg, NC 28027 | 2019-05-28 |
| 1639648306 | Kristen Morris Spell | Counselor | 195 Lower Cape Dr Sw Apt 107, Concord, NC 28027 | 2018-11-25 |
| 1568959625 | Laurie Ford | Counselor | 705 Samuel Adams Cir Sw, Concord, NC 28027 | 2018-04-15 |
| 1598278194 | Autumn Nobles | Specialist/Technologist | 10193 Falling Leaf Dr Nw, Concord, NC 28027 | 2017-11-06 |
| 1386192938 | Brundasudha Satti IIi | Physical Therapist | 379 Sutoforest Dr Nw, Concord, NC 28027 | 2016-09-12 |
| 1467809616 | Kathryn Teal Watts | Dentist | 5305345 Vining St Nw, #201, Concord, NC 28027 | 2016-05-18 |
| 1720443849 | Denette Carte | Health Educator | 9712 Ravenscroft Lane Nw, Concord, NC 28027 | 2015-12-16 |
| Find all providers in zip 28027 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497075402 | Nantucket Pediatrics | Pediatrics | 390 Westford Rd, Concord, MA 01742-5236 | 2010-06-02 |
| 1437385168 | Amy Schafer Boger | Pediatrics | 243 Old Pickard Rd, Concord, MA 01742-4727 | 2009-06-09 |
| 1811184088 | Candice K Smith | Pediatrics | 1699 Baywood Dr, Concord, CA 94521-1252 | 2007-10-01 |
| 1952507899 | George Alfred Engstrom | Pediatrics | 700 Williamsburg Ct Ne, Concord, NC 28025-2540 | 2007-06-26 |
| 1982727004 | Charlotte C Cowan | Pediatrics | 281 A Fairhaven Hill, Concord, MA 01742 | 2007-04-06 |
| 1679589212 | Concord Children's Clinic | Pediatrics | 1040 Vinehaven Dr, Concord, NC 28025 | 2006-08-01 |
| 1700802543 | Todd Michael Poret | Pediatrics | 253 Pleasant Street, Dept of Pediatrics, Concord, NH 03301 | 2006-07-14 |
| 1538192604 | Hemant Prakash | Pediatrics | 1040 Vinehaven Drive, Concord, NC 28025 | 2006-07-09 |
| 1225076524 | Lisa M Kelly | Pediatrics | 133 Ornac, Emerson Hospital, Concord, MA 01541 | 2006-06-02 |
| 1699741579 | Joseph Stegman | Pediatrics | 301 Medical Park Dr, Ste 202b, Concord, NC 28025-2981 | 2006-02-28 |
| Find all providers in CONCORD | ||||
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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.