NOVANT MEDICAL GROUP, INC. (NPI# 1902846330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902846330 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC. |
| Other Organization Name | NOVANT HEALTH GYNECOLOGIC ONCOLOGY ASSOCIATES |
| Practice Address |
1918 Randolph Rd Ste 175 Charlotte NC 28207-1107 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043848200 |
| Practice Fax Number | 7043848208 |
| Mailing Telephone | 7043847840 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-08-01 |
| Authorized Official Name | GEOFFREY GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043848200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS NC | 015KR | 01 |
| SC | NPB048 | 05 | |
| NC | 89015KR | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Gynecologic Oncology Associates | 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 |
1918 RANDOLPH RD STE 175 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720599061 | Novant Medical Group, Inc | Emergency Medicine | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2017-10-13 |
| 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 | 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 |
|---|---|---|---|---|
| 1477171759 | The Presbyterian Hospital | Obstetrics & Gynecology | 125 Queens Rd Ste 540, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1174966451 | Brittany Lees | Obstetrics & Gynecology | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2013-04-17 |
| 1114285350 | Malcolm Strachan Ross | Obstetrics & Gynecology | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2012-04-25 |
| 1750594800 | Erin Crane | Obstetrics & Gynecology | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2007-05-07 |
| 1720201643 | Carolina's Cancer Care 2llc | Obstetrics & Gynecology | 411 Billingsley Rd, Suite 103, Charlotte, NC 28211-1046 | 2007-04-10 |
| 1972685105 | Jubilee Brown | Obstetrics & Gynecology | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2006-10-19 |
| 1730196098 | Robert Naumann | Obstetrics & Gynecology | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2006-08-01 |
| 1063429322 | Robert Higgins | Obstetrics & Gynecology | 1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990 | 2006-08-01 |
| 1215969613 | David Tait | Obstetrics & Gynecology | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2006-07-07 |
| 1881679439 | Brigitte Miller | Obstetrics & Gynecology | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2005-12-07 |
| 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.