Novant Medical Group, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Novant Health Parker Internal Medicine

Practice address

330 Billingsley Rd
Suite 101
Charlotte, NC 28211-5020

Phone

(704) 384-1605

Fax

(704) 384-1610

NPI assigned

Jun 7, 2006

Last updated

Jul 31, 2013By 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

Geoffery Gardner

Title

VP Finance

Phone

(704) 384-7283

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Novant Health Parker Internal Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1114967619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602362",
            "telephone_number": "704-384-1605",
            "fax_number": "704-384-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BILLINGSLEY RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282115020",
            "telephone_number": "704-384-1605",
            "fax_number": "704-384-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFERY",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "704-384-7283"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "015YP",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015YP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Parker Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Novant Medical Group, Inc. (Novant Health Pediatric Allergy & Immunology)
• Novant Medical Group, Inc. (Presbyterian Newborn Specialists)
• Novant Medical Group, Inc. (South Charlotte Center for Gynecology & Pelvic Surgery)
• Novant Medical Group, Inc. (Mid Carolina Cardiology)
• Novant Medical Group, Inc.

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.