NPIMap

Organization Active NPI

Novant Medical Group, Inc

Doing business as Novant Health Northlake Neurology

  • Neurology Physician
  • Huntersville, NC
National Provider Identifier
1073998787
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NOVANT MEDICAL GROUP, INC
Doing business as
Novant Health Northlake Neurology
Practice address
6909 Prosperity Church Rd
Huntersville, NC 28078-6698
Phone
(704) 316-5388
Fax
(704) 316-1848
NPI assigned
Jul 23, 2015
Last updated
Jul 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Geoffrey K Gardner
Title
VP of Finance
Phone
(704) 316-5388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

6909 Prosperity Church Rd
Huntersville, NC 28078-6698

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5388

Other names 1

  • Novant Health Northlake Neurology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Inpt Care503 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1073998787",
    "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",
            "telephone_number": "704-316-5388",
            "fax_number": "704-316-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 PROSPERITY CHURCH RD",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786698",
            "telephone_number": "704-316-5388",
            "fax_number": "704-316-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "704-316-5388"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Northlake Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.