Novant Medical Group, Inc.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Novant Health Brain and Spine Surgery

Practice address

1900 Randolph Rd Ste 1010
Charlotte, NC 28207-1117

Phone

(704) 316-3070

Fax

(704) 316-3071

NPI assigned

Oct 11, 2017

Last updated

Aug 16, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shala Davis

Title

RCS Manager

Phone

(704) 303-7517

Specialties & licenses 1

Addresses

Other names 1

• Novant Health Brain and Spine Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christina Un Cepeda-Chyr, PA-C

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1447829619
  NPD
• William Tommy Sparks, PA

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1366040503
  NPD
• Kristen Elizabeth Vance, PA-C

  • Physician Assistant
  • Cornelius, NC
  • NPI 1407372568
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1073023503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD STE 1010",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071117",
            "telephone_number": "704-316-3070",
            "fax_number": "704-316-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Queens Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043217",
            "country_code": "US",
            "telephone_number": "704-316-3070",
            "fax_number": "704-316-3071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Brain and Spine Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Brain and Spine Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Medical Group, Inc. (Novant Health Pediatric Gastroenterology)
• Novant Medical Group, Inc. (Novant Health Internal Medicine Providence)
• Novant Medical Group, Inc. (Novant Health Hepatobillary & Pancreas)
• Novant Medical Group, Inc. (Mint Hill Family Practice)
• Novant Medical Group, Inc. (Novant Health NoDa OBGYN)
• Novant Medical Group, Inc. (Novant Health Pediatrics Plaza Midwood)
• Novant Medical Group, Inc. (Presbyterian Sleep Lab Ballantyne)
• Novant Medical Group, Inc. (Novant Health Women's Heart & Vascular Center)
• Novant Medical Group, Inc. (North Charlotte Sleep Health)
• Novant Medical Group, Inc. (Novant Health Heart and Vascular Institute)

• Neurological Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Neurological Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.