Novant Medical Group, Inc
Organization Active NPI Family Medicine Physician · Sunset Beach, NC
NPI 1457750838 · NPPES record last updated Aug 21, 2014
Key facts
- NPI
- 1457750838
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NOVANT MEDICAL GROUP, INC
- Practice address
- 710 Sunset Blvd N
Suite a
Sunset Beach, NC 28468-4345 - Phone
- (704) 384-7606
- Fax
- (336) 277-7722
- NPI assigned
- Aug 21, 2014
- Organization subpart
- No
Authorized official
- Name
- Geoffrey K Gardner
- Title
- VP of Finance
- Phone
- (704) 384-7606
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | NC | Yes |
Addresses
Primary practice location
710 Sunset Blvd N
Suite a
Sunset Beach, NC 28468-4345
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7606
Other names
- Novant Health Seaside Family Medicine
Other providers in Sunset Beach, NC
- McLeod Physician Associates II
- Joan Hanlon Morris
- Dennis Ryan Napier
- Cindy Ni
- Novant Medical Group Inc
- Novant Medical Group, Inc.
- Ryleigh Pabon
- Joshua Cole Pridgen
- Amanda Rae Ruda
- Sonya S Saadati
All providers in Sunset Beach, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.