Novant Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP INC

Doing business as

Novant Health Granite Quarry Internal Medicine & Pediatrics

Practice address

111 S Salisbury GQ Ave
Salisbury, NC 28146-8150

Phone

(704) 279-1679

Fax

(704) 279-1677

NPI assigned

Oct 28, 2009

Last updated

Jul 10, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

NOVANT MEDICAL GROUP, INCAs reported in NPPES

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

Authorized official

Name

Leea Jeanine Walton

Title

RCS Manager

Phone

(704) 316-6081

Specialties & licenses 2

Addresses

Other names 1

• Novant Health Granite Quarry Internal Medicine & Pediatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Presbyterian Inpt Care

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1104152024",
    "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": "704-279-1679",
            "fax_number": "704-279-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S SALISBURY GQ AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281468150",
            "telephone_number": "704-279-1679",
            "fax_number": "704-279-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVANT MEDICAL GROUP, INC",
        "enumeration_date": "2009-10-28",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Granite Quarry Internal Medicine & Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Granite Quarry Internal Medicine & Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Rowan Medical Center LLC
• Novant Health Rowan Medical Center, LLC (Psychiatric Unit)
• Novant Health Rowan Medical Center, LLC (NH Rowan Cancer Clinics)
• Novant Health Rowan Medical Center, LLC (Rehabilitation Unit)
• Novant Health Rowan Medical Center, LLC (Novant Health Cancer Institute)
• Novant Medical Group Inc (Novant Health Heart and Vascular Institute)
• Novant Medical Group Inc (Novant Health Vascular Specialists)
• Novant Medical Group Inc (Novant Health Psychiatric Recovery and Counseling)
• Novant Medical Group Inc (Novant Health Rowan Pediatrics)
• Novant Medical Group Inc (Novant Health Psychiatry)

• Family Medicine Physician in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.