NPIMap

Organization Active NPI

Novant Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Denver, NC
National Provider Identifier
1477609592
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NOVANT MEDICAL GROUP, INC.
Practice address
269 Gillman Rd Ste 200a
Denver, NC 28037-7919
Phone
(704) 316-1150
Fax
(704) 316-1151
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Authorized official

Name
Geoffrey Gardner
Title
VP Finance
Phone
(704) 384-7283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X NC Primary

Addresses

Primary practice location

269 Gillman Rd Ste 200a
Denver, NC 28037-7919

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1150

Other identifiers 3

IdentifierTypeStateIssuer
018X4OtherNCBCBS
5905988MedicaidNC
CC5118OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031201000123 NC Part B Supplier - Clinic/Group Practice 3678478054 Receives reassigned benefits from 55 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, NC; Randleman, NC; Raleigh, NC; Monroe, NC; Matthews, NC; Jamestown, NC; Huntersville, NC; Hickory, NC…
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
Forsyth Medical Group LLC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

5370 Ridge Rd
Ste D1
Charlotte, NC 28269
Phone (704) 316-1581

9930 Kincey Ave
Ste 360
Huntersville, NC 28078

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1477609592",
    "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": "704-316-1150",
            "fax_number": "704-316-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 GILLMAN RD STE 200A",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280377919",
            "telephone_number": "704-316-1150",
            "fax_number": "704-316-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "704-384-7283"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "018X4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905988",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC5118",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.