NOVANT MEDICAL GROUP, INC (NPI# 1952842833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952842833 |
| Entity Type | Organization |
| Organization Name | NOVANT MEDICAL GROUP, INC |
| Other Organization Name | NOVANT HEALTH PSYCHIATRIC RECOVERY AND COUNSELING |
| Practice Address |
1401 Matthews Township Pkwy Suite 320 Matthews NC 28105-5402 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043167585 |
| Practice Fax Number | 7043386422 |
| Mailing Telephone | 7043167585 |
| Mailing Fax Number | 7043386422 |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043167585 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Psychiatric Recovery and Counseling | 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 |
1401 MATTHEWS TOWNSHIP PKWY SUITE 320 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760471221 | Irving David Wight | Physician Assistant | 1401 Matthews Township Pkwy, Suite 101, Matthews, NC 28105-5402 | 2005-10-18 |
| 1023574191 | Tarah Faust | Physical Therapy Assistant | 1401 Matthews Township Pkwy, Matthews, NC 28105-5402 | 2019-02-14 |
| 1427596329 | Claudiu Samuel Mioc | Physician Assistant | 1401 Matthews Township Pkwy, Suite 380, Matthews, NC 28105-5402 | 2017-02-10 |
| 1942748538 | Chelsea Hopkins | Physician Assistant | 1401 Matthews Township Pkwy, Matthews, NC 28105-5402 | 2017-02-03 |
| 1326597493 | Novant Medical Group, Inc | Social Worker | 1401 Matthews Township Pkwy, Suite 320, Matthews, NC 28105-5402 | 2016-09-29 |
| 1174071229 | Donna C Knowlton Dds Pllc | Dentist | 1401 Matthews Township Pkwy, Ste 210, Matthews, NC 28105-5402 | 2016-09-19 |
| 1740645886 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1401 Matthews Township Pkwy, Suite 100, Matthews, NC 28105-5402 | 2015-12-16 |
| 1861861346 | Carolina Neurosurgery & Spine Associates, Pa | Neurological Surgery | 1401 Matthews Township Pkwy, Suite 300, Matthews, NC 28105-5402 | 2015-09-15 |
| 1194152512 | Novant Medical Group, Inc. | Pediatrics | 1401 Matthews Township Pkwy, Suite 100, Matthews, NC 28105-5403 | 2013-09-30 |
| 1114267085 | Novant Medical Group, Inc. | Pediatrics | 1401 Matthews Township Pkwy, Suite 312, Matthews, NC 28105-5402 | 2013-02-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710959788 | Jonathan K Stoudmire | Psychiatry & Neurology | 3046 Senna Dr, Suite B, Matthews, NC 28105-6726 | 2006-02-03 |
| 1669854048 | Kris Ruangchotvit | Psychiatry & Neurology | 1401 Matthews Township Pkwy Ste 320, Matthews, NC 28105 | 2015-06-23 |
| 1790103547 | Siera Marie Kirkland | Psychiatry & Neurology | 1401 Matthews Township Pkwy Ste 320, Matthews, NC 28105-5403 | 2014-03-30 |
| 1669650073 | Outlook Forensic & Behavioral Health | Psychiatry & Neurology | 2427 Plantation Center Dr, Matthews, NC 28105-6204 | 2008-02-07 |
| 1285827402 | Kalpana Shanmugam | Psychiatry & Neurology | 1401 Matthews Township Pkwy Ste 320, Matthews, NC 28105-5403 | 2007-08-21 |
| 1144250663 | Fred Welden Caudill | Psychiatry & Neurology | 130 Matthews Station St, Suite 2-b, Matthews, NC 28105-6719 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851696 | Cana Psychiatric Health | Psychiatry & Neurology | 1846 E Innovation Park Dr #100, Oro Valley, NC 27502-2750 | 2020-11-04 |
| 1750999876 | Integral Mental Healthcare Pllc | Psychiatry & Neurology | 1105 Walnut St Ste F-16031, Cary, NC 27511-4762 | 2020-07-14 |
| 1740808096 | Best Day Psychiatry and Counseling, PC | Psychiatry & Neurology | 4905 Pine Cone Dr Ste 9, Durham, NC 27707-5258 | 2020-07-13 |
| 1851917710 | Lux Psychiatry, Pllc | Psychiatry & Neurology | 101 Colvard Street, Jefferson, NC 28640 | 2020-06-17 |
| 1639792245 | Summit Health Psychiatry, PC | Psychiatry & Neurology | 226 Shannon Rd, Hendersonville, NC 28791-8739 | 2020-05-19 |
| 1083240592 | Sabrina Michelle Campbell | Psychiatry & Neurology | 1601 Brenner Ave Bldg 8-1, Salisbury, NC 28144-2515 | 2020-03-16 |
| 1457986416 | Benjamin Boris Brodey | Psychiatry & Neurology | 201 E Rosemary St, Chapel Hill, NC 27514-3529 | 2020-03-10 |
| 1538794276 | Carolina Psychiatry Center, Pllc | Psychiatry & Neurology | 301 Keisler Dr Ste A, Cary, NC 27518-7018 | 2020-03-03 |
| 1568002608 | Avant Medical Consulting Pllc | Psychiatry & Neurology | 109 Rosegarten Ct, New Bern, NC 28562-1016 | 2020-01-07 |
| 1518503994 | Mental Health Associates and Addiction | Psychiatry & Neurology | 1944 Hendersonville Rd # D-1a, Asheville, NC 28803-2351 | 2019-11-21 |
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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.