Novant Medical Group, Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NOVANT MEDICAL GROUP, INC

Doing business as

Novant Health Memory Center

Practice address

2801 Randolph Rd
Suite 101
Charlotte, NC 28211-1051

Phone

(704) 384-7910

Fax

(704) 316-2015

NPI assigned

Mar 1, 2013

Last updated

Jul 3, 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

Geoffrey K Gardner

Title

VP of Finance

Phone

(704) 384-9094

Specialties & licenses 1

Addresses

Other names 1

• Novant Health Memory Center 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": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1235479155",
    "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": "704-384-7910",
            "fax_number": "704-316-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 RANDOLPH RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111051",
            "telephone_number": "704-384-7910",
            "fax_number": "704-316-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-07-03",
        "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": "704-384-9094"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Memory Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Medical Group, Inc (Novant Health Pulmonary & Critical Care)
• Novant Medical Group, Inc (Novant Health Rehabilitation Center)
• Novant Medical Group, Inc (Novant Health Thoracic Surgery)
• Novant Medical Group, Inc (Novant Health Psychiatric Integrated Care)
• Novant Medical Group, Inc (Novant Health Midtown OB/GYN)
• Novant Medical Group, Inc (Novant Health Sleep Center)
• Novant Medical Group, Inc (Novant Health Multidisciplinary Cancer Clinic)
• Novant Medical Group, Inc
• Novant Medical Group, Inc (Presbyterian Urgent Care)
• Novant Medical Group, Inc (Presbyterian Bariatric&General Surgery)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.