NOVANT MEDICAL GROUP, INC (NPI# 1720599061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720599061 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH INTEGRATIVE MEDICINE |
| Practice Address |
1918 Randolph Rd Ste 175 Charlotte NC 28207-1107 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165222 |
| Practice Fax Number | 7043161386 |
| Mailing Telephone | 7043847840 |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2019-08-01 |
| 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 | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Integrative Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
| 1710444294 | Novant Medical Group, Inc | Orthopaedic Surgery | 167 Moore Rd Ste 202, King, NC 27021-8770 | 2019-02-21 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
| 1649786575 | Novant Medical Group, Inc | Physical Therapist | 8045 Providence Rd Ste 100, Charlotte, NC 28277-8916 | 2017-12-14 |
| 1962953877 | Novant Medical Group, Inc | Internal Medicine | 9550 Rocky River Rd Ste 100, Charlotte, NC 28215 | 2016-10-17 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1881096907 | Novant Medical Group, Inc | Internal Medicine | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2014-09-19 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 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 |
1918 RANDOLPH RD STE 175 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902846330 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2006-06-07 |
| 1114285350 | Malcolm Strachan Ross | Obstetrics & Gynecology | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2012-04-25 |
| 1801961404 | Madhavi Parikh | Physician Assistant | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2006-11-21 |
| 1669482386 | Russell Howard Greenfield | Emergency Medicine | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2006-08-08 |
| 1376562108 | Lisa Jervis | Obstetrics & Gynecology | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164021051 | Onespotmd Primary and Urgent Care Pllc | Emergency Medicine | 2017 Central Ave Ste 103, Charlotte, NC 28205-5388 | 2020-10-21 |
| 1750909032 | The Presbyterian Hospital | Emergency Medicine | 125 Queens Rd Ste 500, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1982225983 | William Bedard Michel | Emergency Medicine | Carolina Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203 | 2020-04-30 |
| 1457988586 | Morgan Mazakas Penzler | Emergency Medicine | 1000 Blythe Blvd Ste 600, Charlotte, NC 28203-5812 | 2020-03-26 |
| 1538620737 | Andrew Yde | Emergency Medicine | Cmc/department of Emergency Medicine, 1000 Blythe Blvd., Charlotte, NC 28203-5812 | 2019-03-29 |
| 1780048348 | Cornelius Powell IIi | Emergency Medicine | Gme1000 Blythe Blvd., Meb, Suite 157, Carolinas Medical Center, Charlotte, NC 28203-2861 | 2016-04-11 |
| 1417185125 | Anil Kumar Chhabra | Emergency Medicine | 14714 Jockeys Ridge Dr, Charlotte, NC 28277-3717 | 2009-07-01 |
| 1669608709 | Anthony L Fox | Emergency Medicine | 8800 N Tyron St, Carolinas Medical Center -university, Charlotte, NC 28262 | 2009-06-03 |
| 1821250697 | Christopher Kirt Kessler | Emergency Medicine | 1133 Metropolitan Ave Unit 618, Charlotte, NC 28204-3401 | 2008-07-01 |
| 1265606784 | Michael Craig Flanders | Emergency Medicine | 8800 North Tryon St, Emp, Charlotte, NC 28262 | 2008-04-16 |
| 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.