NPIMap

Organization Active NPI

Nova Physician Group PLLC

  • Internal Medicine Physician
  • Greensboro, NC
National Provider Identifier
1417704289
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NOVA PHYSICIAN GROUP PLLC
Practice address
3808 W Gate City Blvd
Greensboro, NC 27407-4713
Phone
(704) 396-7143
Fax
(980) 305-5123
NPI assigned
May 1, 2024
Last updated
May 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Dr. Terrence Morton Jr.
Title
Sr. Medical Director
Phone
(773) 733-9730

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

3808 W Gate City Blvd
Greensboro, NC 27407-4713

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (773) 352-1515

National Provider Directory

National Provider Directory
Tax ID family
Nova Physician Group PLLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

3808 W Gate City Blvd
Greensboro, NC 27407
Phone (336) 518-7008

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1417704289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 W GATE CITY BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274074713",
            "telephone_number": "704-396-7143",
            "fax_number": "980-305-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PHYSICIAN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "SR. MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-733-9730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.