Novant Medical Group, Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Novant Medical Group, Inc.

Practice address

8820 Rachel Freeman Way
Charlotte, NC 28278-9510

Phone

(704) 316-2322

Fax

(704) 316-1682

NPI assigned

Mar 8, 2018

Last updated

Aug 17, 2021By 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

Shala Davis

Title

RCS Manager

Phone

(704) 303-7517

Specialties & licenses 1

Addresses

Other names 1

• Novant Medical Group, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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.

• Connie Marie Mann, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
  • NPI 1932708039
  NPD

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1215430954",
    "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": "8820 RACHEL FREEMAN WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282789510",
            "telephone_number": "704-316-2322",
            "fax_number": "704-316-1682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13425 Hoover Creek Boulevard",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28273",
            "country_code": "US",
            "telephone_number": "704-384-1246",
            "fax_number": "704-384-6072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Medical Group, Inc. (Novant Health Parker Internal Medicine)
• 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. (Novant Health McKee Medical Group)
• Novant Medical Group, Inc. (Novant Health Maternal and Fetal Medicine)
• Novant Medical Group, Inc. (Novant Health Rehabilitation Center)
• Novant Medical Group, Inc. (Mid Carolina Cardiology - University)
• Novant Medical Group, Inc. (NHMG Occupational Medicine Clinics)

• Psychiatry Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.