NPIMap

Organization Active NPI

Novant Medical Group, Inc

Doing business as Novant Health Rehabilitation Center

  • Physical Therapist
  • Denver, NC
National Provider Identifier
1174047427
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NOVANT MEDICAL GROUP, INC
Doing business as
Novant Health Rehabilitation Center
Practice address
269 Gillman Rd Ste 200B
Denver, NC 28037-7919
Phone
(704) 316-3104
Fax
(704) 316-3105
NPI assigned
Jul 28, 2017
Last updated
Aug 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
Shala Davis
Title
Manager
Phone
(704) 303-7517

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Audiologist 231H00000X NU
Speech-Language Pathologist 235Z00000X NU
Audiologist-Hearing Aid Fitter 237600000X NU

Addresses

Primary practice location

269 Gillman Rd Ste 200B
Denver, NC 28037-7919

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Novant Health Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000692 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 3,607 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Specialty503 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

Locations

656 E Monmouth St
Winston Salem, NC 27107
Phone (336) 718-4380

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1174047427",
    "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": "269 GILLMAN RD STE 200B",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280377919",
            "telephone_number": "704-316-3104",
            "fax_number": "704-316-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.