Novant Medical Group. Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP. INC.

Practice address

2150 Country Club Rd Ste 300
Winston Salem, NC 27104-4241

Phone

(336) 277-5881

Fax

(336) 277-7823

NPI assigned

Dec 21, 2017

Organization subpart

No

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) 384-7840

Specialties & licenses 1

Addresses

Other names 1

• Novant Health Care Connections Provider Services Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1558877902",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 COUNTRY CLUB RD STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044241",
            "telephone_number": "336-277-5881",
            "fax_number": "336-277-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2018-03-15",
        "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": "704-384-7840"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Care Connections Provider Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novel Me Counseling and Consultation, PLLC
• Sarah E Novelly Rush, RD
• Jackson Nowatzke
• Maria Cristina Noyola, LPCA
• NRS Arizona, PA

• All providers in Winston Salem, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.