Novant Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Novant Health Family Medicine Associates

Practice address

207 Church St
Clover, SC 29710-1008

Phone

(803) 222-3063

Fax

(803) 222-3064

NPI assigned

May 10, 2006

Last updated

Jun 27, 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 Gardner

Title

VP of Operations

Phone

(704) 384-9094

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Novant Health Family Medicine Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Novant Health Medical Group, LLC

  dba Novant Health Rock Hill Family Medicine

  • Family Medicine Physician
  • Rock Hill, SC
  • NPI 1649227083

  O20051115000335

  Same enrollment
• Novant Medical Group, Inc.

  dba Novant Health Maternal-Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Rock Hill, SC
  • NPI 1033566278

  O20051115000335

  Same enrollment
• Novant Medical Group, Inc.

  dba Novant Health Fort Mill Family Medicine

  • Family Medicine Physician
  • Fort Mill, SC
  • NPI 1205899861

  O20051115000335

  Same enrollment
• Novant Medical Group, Inc.

  dba Metrolina Medical Associates

  • Family Medicine Physician
  • Rock Hill, SC
  • NPI 1790743474

  O20051115000335

  Same enrollment
• Novant Medical Group, Inc.

  dba Novant Health Family Medicine Associates

  • Family Medicine Physician
  • York, SC
  • NPI 1922060557

  O20051115000335

  Same enrollment
• Novant Health Medical Group, LLC

  dba Novant Health Pulmonary Medicine South

  • Pulmonary Disease Physician
  • Monroe, NC
  • NPI 1033664933

  O20051115000335

  Same enrollment

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1376593590",
    "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": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 CHURCH ST",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297101008",
            "telephone_number": "803-222-3063",
            "fax_number": "803-222-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "704-384-9094"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4331",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Family Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Joanna Myrick, D.M.D.
• Ernest Lloyd Myrick Jr., D.M.D.
• New Beginnings Behavioral Health
• Tatum Newbill
• Marcia Lynne Nibert, D.C., LAC
• Simren Patel, PA-C
• Marion Patterson
• Abhinaya Muralidharan Perumbedu
• Jill Ann Pierce, MS, CCC/SLP
• Yasmin Plummer, LPN

• Family Medicine Physician in Clover, SC
• Providers in Clover, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.