NOVANT MEDICAL GROUP, INC (NPI# 1942745807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942745807 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH STROKE BRIDGE CLINIC |
| Practice Address |
1918 Randolph Rd Suite 400 Charlotte NC 28207-1100 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043849437 |
| Practice Fax Number | 7043849440 |
| Mailing Telephone | 7043849437 |
| Mailing Fax Number | 7043849440 |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-01-03 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043849437 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Stroke Bridge Clinic | 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 SUITE 400 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588660625 | Christopher John Danner | Specialist | 1918 Randolph Rd, Ste. 300, Charlotte, NC 28207-1100 | 2005-06-23 |
| 1659727881 | Katherine Mcclure | Physician Assistant | 1918 Randolph Rd, Suite 400, Charlotte, NC 28207-1100 | 2016-05-06 |
| 1467810531 | Kristina Hendley Sapel | Physician Assistant | 1918 Randolph Rd, Suite 550, Charlotte, NC 28207-1100 | 2016-02-04 |
| 1376910877 | Elaine Mejia | Physician Assistant | 1918 Randolph Rd, Suite 220, Charlotte, NC 28207-1100 | 2015-09-01 |
| 1437552114 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1918 Randolph Rd, Suite 275-a, Charlotte, NC 28207-1100 | 2014-10-08 |
| 1245630854 | Mary Meredith Gillis | Psychologist | 1918 Randolph Rd, Suite 400, Charlotte, NC 28207-1100 | 2014-09-02 |
| 1093136939 | Amy Vischetti Moore | Physician Assistant | 1918 Randolph Rd, Ste. 580, Charlotte, NC 28207-1100 | 2013-12-19 |
| 1962831651 | Candice Halle Kessler | Nurse Practitioner | 1918 Randolph Rd, Suite 670, Charlotte, NC 28207-1100 | 2013-11-04 |
| 1184059958 | Alicja Erazo Sundblade | Registered Nurse | 1918 Randolph Rd, Suite 350, Charlotte, NC 28207-1100 | 2013-09-11 |
| 1710228077 | Novant Medical Group Inc | Obstetrics & Gynecology | 1918 Randolph Rd, Suite 300, Charlotte, NC 28207-1100 | 2013-03-12 |
| Find all providers in the same location | ||||
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578056057 | Novant Medical Group, Inc. | Psychiatry & Neurology | 15033 Ballancroft Pkwy Ste 200, Charlotte, NC 28277-4944 | 2018-06-11 |
| 1477992063 | Neil Ghanshyam Patel | Psychiatry & Neurology | 2801 Randolph Rd Ste 101, Charlotte, NC 28211-1051 | 2013-06-18 |
| 1437444346 | Megan Tudor Donnelly | Psychiatry & Neurology | 2801 Randolph Road Suite 101, Charlotte, NC 28211 | 2011-06-20 |
| 1992983589 | Sheela Myers | Psychiatry & Neurology | 10660 Park Road, Suite 4400, Charlotte, NC 28210 | 2008-02-05 |
| 1720161011 | Michael M Amiri | Psychiatry & Neurology | 1300 Baxter St Ste 114, Charlotte, NC 28204-3806 | 2006-10-23 |
| 1144321373 | Henry Joseph Horacek Jr. | Psychiatry & Neurology | 10716 Carmel Commons Blvd, Suite 120, Charlotte, NC 28226-3783 | 2006-09-26 |
| 1659322691 | Mohammad R. Bolouri | Psychiatry & Neurology | 7809 Sardis Rd, Charlotte, NC 28270-2757 | 2006-05-15 |
| 1013968858 | Richard David Jacobson | Psychiatry & Neurology | 4228 Brookfield Dr, Charlotte, NC 28210 | 2006-05-15 |
| 1306896592 | Kenneth Todd Ashkin | Psychiatry & Neurology | 8045 Providence Rd Ste 200, Charlotte, NC 28277-9724 | 2006-05-11 |
| 1336199587 | Thor Erik Borresen | Psychiatry & Neurology | 1900 Scott Ave, Charlotte, NC 28203-6046 | 2006-05-10 |
| 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.