Novant Medical Group Inc

Organization Active NPI Physical Therapist · Huntersville, NC

NPI 1407197643 · NPPES record last updated Aug 17, 2021

Key facts

NPI
1407197643
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
NOVANT MEDICAL GROUP INC
Practice address
14330 Oakhill Park LN Ste 115
Huntersville, NC 28078-3479
Phone
(704) 316-1265
Fax
(704) 316-1266
NPI assigned
Mar 13, 2013
Organization subpart
No

Authorized official

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

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040204001028 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 648 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Denver, NC; High Point, NC; Huntersville, NC; Indian Trail, NC; Matthews, NC; Monroe, NC; Mooresville, NC; Salisbury, NC…

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

14330 Oakhill Park LN Ste 115
Huntersville, NC 28078-3479

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1635

Other names

  • Novant Health Lakeside Physical Therapy & Sports Medicine Doing business as

Other providers in Huntersville, NC

All providers in Huntersville, NC · Physical Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.