Novant Medical Group, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Novant Urgent Care Southport

Practice address

1456 N Howe St
Suite 100
Southport, NC 28461-2754

Phone

(910) 454-8889

Fax

(910) 454-8890

NPI assigned

Sep 13, 2007

Last updated

Jun 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dinesh S Pai

Title

VP of Operations

Phone

(704) 384-9104

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Novant Urgent Care Southport 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": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1588859342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 N HOWE ST",
            "address_2": "SUITE 100",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612754",
            "telephone_number": "910-454-8889",
            "fax_number": "910-454-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 N HOWE ST",
            "address_2": "SUITE 100",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612754",
            "telephone_number": "910-454-8889",
            "fax_number": "910-454-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "PAI",
        "authorized_official_first_name": "DINESH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "704-384-9104"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "019V6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Urgent Care Southport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group, LLC (Novant Health Surgical Associates)
• Novant Health Medical Group, LLC (Novant Health Coastal Plastic Surgery)
• Novant Medical Group Inc (Novant Health Urology Partners)
• Novant Medical Group, Inc. (Orthopaedic Specialists)
• Novant Medical Group, Inc. (Southport Internal Medicine)
• Novant Medical Group, Inc. (Heart Specialists of Brunswick)
• Novant Medical Group, Inc. (James B. Adams, MD Internal Medicine)
• Edgar E Null, FNP-C
• O.T. Center Inc.
• John Cameron O'Brien Jr., D.C.

• Urgent Care Clinic/Center in Southport, NC
• Providers in Southport, NC by specialty
• Urgent Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.