NPIMap

Organization Active NPI

Novant Medical Group, Inc.

Doing business as Novant Health Pediatric Sleep Medicine

  • Pediatric Sleep Medicine Physician
  • Charlotte, NC
National Provider Identifier
1477092179
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sleep Medicine PhysicianTaxonomy code 2080S0012X
Legal business name
NOVANT MEDICAL GROUP, INC.
Doing business as
Novant Health Pediatric Sleep Medicine
Novant Health Pediatric Sleep Specialists
Practice address
1900 Randolph Rd Ste 1010
Charlotte, NC 28207-1117
Phone
(704) 316-1062
Fax
(704) 384-1063
NPI assigned
Feb 15, 2017
Last updated
Sep 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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 Finance
Phone
(704) 384-9672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sleep Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080S0012X Primary

Addresses

Primary practice location

1900 Randolph Rd Ste 1010
Charlotte, NC 28207-1117

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1062

Other names 2

  • Novant Health Pediatric Sleep Medicine Doing business as
  • Novant Health Pediatric Sleep Specialists Doing business as

Medicare participation

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

Enrollment records 1

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

National Provider Directory
Tax ID family
Presbyterian Inpt Care503 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

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537228800000",
    "number": "1477092179",
    "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": "704-316-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD STE 1010",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071117",
            "telephone_number": "704-316-1062",
            "fax_number": "704-384-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-15",
        "last_updated": "2018-09-18",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "704-384-9672"
    },
    "taxonomies": [
        {
            "code": "2080S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Pediatric Sleep Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Pediatric Sleep Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.