NPIMap

Organization Active NPI

Novant Medical Group, Inc.

Doing business as Gill Orthopaedics Clinic

  • Orthopaedic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1508052242
Registry record updated Nov 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NOVANT MEDICAL GROUP, INC.
Doing business as
Gill Orthopaedics Clinic
Practice address
1918 Randolph Rd
Suite 700
Charlotte, NC 28207-1167
Phone
(704) 342-3544
Fax
(704) 370-6652
NPI assigned
Sep 17, 2007
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 Gardner
Title
VP of Operations
Phone
(704) 384-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1918 Randolph Rd
Suite 700
Charlotte, NC 28207-1167

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 342-3544

Other identifiers 3

IdentifierTypeStateIssuer
5908361MedicaidNC
019PVOtherNCBCBS-NC
1508052242OtherNCPARTNERS

Other names 1

  • Gill Orthopaedics Clinic 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

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385683200000",
    "number": "1508052242",
    "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": "704-342-3544",
            "fax_number": "704-370-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 700",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071167",
            "telephone_number": "704-342-3544",
            "fax_number": "704-370-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2013-11-29",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "704-384-9094"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908361",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC",
            "identifier": "019PV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "1508052242",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gill Orthopaedics Clinic",
            "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 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.