NOVANT MEDICAL GROUP, INC. (NPI# 1861520074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861520074 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH PROVIDENCE OB/GYN |
| Practice Address |
1718 E 4th St Suite 907 Charlotte NC 28204-3282 |
| Mailing Address |
Po Box 602362 Charlotte NC 28260-2362 |
| Practice Telephone | 7043724000 |
| Practice Fax Number | 7043344855 |
| Mailing Telephone | 7043724000 |
| Mailing Fax Number | 7043344855 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2013-07-05 |
| Authorized Official Name | GEOFFREY K. GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043724000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS NC | 011VY | 01 |
| NC | 5907955 | 05 | |
| SC | NPB255 | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Providence OB/GYN | 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 |
1718 E 4TH ST SUITE 907 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841298239 | Kevin Hsu | Internal Medicine | 1718 E 4th St, Ste 501, Charlotte, NC 28204-3260 | 2005-07-11 |
| 1205373081 | Miranda L Williams | Physician Assistant | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2017-01-31 |
| 1881138873 | Shannon Scandone | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-12-09 |
| 1063963866 | Jessica Puskarich | Nurse Practitioner | 1718 E 4th St, Suite 307, Charlotte, NC 28204-3261 | 2016-10-18 |
| 1801343793 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 601, Charlotte, NC 28204-3261 | 2016-09-08 |
| 1497107536 | Kelly J Coleman | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-07-12 |
| 1447616602 | Lindsay Spears Taylor | Physician Assistant | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2016-01-04 |
| 1982089322 | Melanie Moshier | Genetic Counselor, MS | 1718 E 4th St, Suite 608, Charlotte, NC 28204-3261 | 2015-07-28 |
| 1962886218 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 401, Charlotte, NC 28204-3261 | 2015-07-16 |
| 1780071373 | Shannon Deluca | Nurse Practitioner | 1718 E 4th St, Suite 501, Charlotte, NC 28204-3261 | 2015-04-21 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 |
|---|---|---|---|---|
| 1649899782 | Atrium Health North Market Network LLC | Obstetrics & Gynecology | 101 E Wt Harris Blvd Ste 5002, Charlotte, NC 28262-3588 | 2020-04-09 |
| 1528617362 | Arboretum Obstetrics & Gynecology | Obstetrics & Gynecology | 3125 Springbank Ln Ste B, Charlotte, NC 28226-3379 | 2019-09-04 |
| 1548624992 | Cassandra Yoder | Obstetrics & Gynecology | 1350 S. Kings Dr., Myers Park Clinic Ob/gyn, Charlotte, NC 28207 | 2016-04-12 |
| 1043690480 | Elizabeth Lindsay Montague-farwell | Obstetrics & Gynecology | 416 E 36th St Su 200, Charlotte, NC 28205 | 2015-06-01 |
| 1285048181 | Katie Mellington Vemireddy | Obstetrics & Gynecology | 8201 Healthcare Loop Ste 302, Charlotte, NC 28215-7072 | 2014-06-18 |
| 1467899948 | Chancy Lucas | Obstetrics & Gynecology | 325 Hawthorne Ln Ste 200, Charlotte, NC 28204 | 2013-05-24 |
| 1750727293 | Stephanie Barbadora-froelich | Obstetrics & Gynecology | 416 E 36th St Ste 200, Charlotte, NC 28205 | 2013-05-10 |
| 1992076509 | Novant Medical Group, Inc | Obstetrics & Gynecology | 11030 Golf Links Dr N, Suite 100, Charlotte, NC 28277-8200 | 2012-01-13 |
| 1073898805 | Novant Medical Group Inc | Obstetrics & Gynecology | 2610 West Arrowood Road, Charlotte, NC 28273-6134 | 2011-10-12 |
| 1164714788 | Patricia Jane Mattingly | Obstetrics & Gynecology | 6324 Fairview Rd Ste 390, Charlotte, NC 28210-4173 | 2011-05-16 |
| 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.