Novant Medical Group, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Practice address

460 Holden Beach Rd
Shallotte, NC 28470-1711

Phone

(910) 755-7779

Fax

(910) 755-7784

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dinesh S Pai

Title

VP of Operations

Phone

(704) 384-9113

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• East Coast Internal Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1386786820",
    "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": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HOLDEN BEACH RD",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284701711",
            "telephone_number": "910-755-7779",
            "fax_number": "910-755-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "PAI",
        "authorized_official_first_name": "DINESH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "704-384-9113"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC",
            "identifier": "020C4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905832",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Coast Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Medical Group Inc
• Novant Medical Group, Inc.
• Katherine O'Connell, LCSW
• Ocean Isle Chiropractic PLLC
• Ocean Isle Operations LLC
• Oceanside Family Medicine

• Internal Medicine Physician in Shallotte, NC
• Providers in Shallotte, 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 Aug 15, 2008; 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.