NPIMap

Organization Active NPI

Novant Medical Group, Inc

Doing business as Novant Health Developmental & Behavioral Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1104162932
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
NOVANT MEDICAL GROUP, INC
Doing business as
Novant Health Developmental & Behavioral Pediatrics
Practice address
6331 Carmel Rd Ste 102
Charlotte, NC 28226
Phone
(704) 384-0567
Fax
(704) 384-0568
NPI assigned
Dec 26, 2012
Last updated
Sep 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Authorized official

Name
Mr. Geoffrey K. Gardner
Title
VP of Finance
Phone
(704) 316-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X Primary

Addresses

Primary practice location

6331 Carmel Rd Ste 102
Charlotte, NC 28226

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-0567

Other practice location 1

3135 Springbank Ln
Suite 100
Charlotte, NC 28226-3360
Phone (704) 316-4445

Other names 1

  • Novant Health Developmental & Behavioral Pediatrics 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": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1104162932",
    "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": "704-384-0567",
            "fax_number": "704-384-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 CARMEL RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "704-384-0567",
            "fax_number": "704-384-0568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3135 Springbank Ln",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282263360",
            "country_code": "US",
            "telephone_number": "704-316-4445",
            "fax_number": "704-316-4446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2018-09-04",
        "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": "704-316-1155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Developmental & Behavioral Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Developmental & Behavioral Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.