Novant Medical Group, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Cascade Primary Care

Practice address

509 Olde Waterford Way
Suite 200
Leland, NC 28451-4125

Phone

(910) 283-1500

Fax

(910) 283-1504

NPI assigned

Dec 19, 2007

Last updated

Aug 15, 2008By 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

Dinesh S. Pai

Title

VP of Operations

Phone

(704) 384-9113

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cascade Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1447434956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLDE WATERFORD WAY",
            "address_2": "SUITE 200",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284514125",
            "telephone_number": "910-283-1500",
            "fax_number": "910-283-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLDE WATERFORD WAY",
            "address_2": "SUITE 200",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284514125",
            "telephone_number": "910-283-1500",
            "fax_number": "910-283-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908896",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group, LLC (Novant Health Express at Walgreens)
• Novant Health Medical Group, LLC (Novant Health Oceanside Family Medicine)
• Novant Health Medical Group, LLC (Novant Health Urology Partners)
• Novant Health Medical Group, LLC (Novant Health Surgical Associates)
• Novant Medical Group, Inc. (Batish Family Medicine)
• Marc H Nudelman, MD
• Matthew James O'Connell, DPT
• Kevin Matthew O'Connor, PA-C
• Tiffane Bennett O'Neil
• Casie O'Rourke

• Internal Medicine Physician in Leland, NC
• Providers in Leland, 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.