NPIMap

Organization Active NPI

Novant Medical Group

Doing business as Novant Health Nutrition Solutions

  • Registered Dietitian
  • Kernersville, NC
National Provider Identifier
1447504063
Registry record updated Nov 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NOVANT MEDICAL GROUP
Doing business as
Novant Health Nutrition Solutions
Practice address
1710 Kernersville Medical Pkwy
Suite 210
Kernersville, NC 27284-7157
Phone
(336) 718-6770
Fax
(336) 277-1889
NPI assigned
Nov 5, 2012
Last updated
Nov 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2013

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

Authorized official

Name
Geoffrey K Gardner
Title
VP of NMG Finance
Phone
(704) 384-9144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1710 Kernersville Medical Pkwy
Suite 210
Kernersville, NC 27284-7157

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-6770

Other names 1

  • Novant Health Nutrition Solutions Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000692 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 3,607 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Specialty503 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385683200000",
    "number": "1447504063",
    "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": "336-718-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 KERNERSVILLE MEDICAL PKWY",
            "address_2": "SUITE 210",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847157",
            "telephone_number": "336-718-6770",
            "fax_number": "336-277-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2013-11-29",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF NMG FINANCE",
        "authorized_official_telephone_number": "704-384-9144"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Nutrition Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.