Novant Medical Group Inc

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

NOVANT MEDICAL GROUP INC

Doing business as

Novant Health Colon and Rectal Clinic

Practice address

7126 Village Medical Cir
Clemmons, NC 27012-8004

Phone

(336) 765-5221

Fax

(336) 765-0430

NPI assigned

May 30, 2014

Last updated

Mar 11, 2015By 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

Geoffrey K. Gardner

Title

VP of Finance

Phone

(336) 765-5221

Specialties & licenses 2

Addresses

Other names 1

• Novant Health Colon and Rectal Clinic 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": "1401408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1619389202",
    "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": "704-384-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7126 VILLAGE MEDICAL CIR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128004",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-30",
        "last_updated": "2015-03-11",
        "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": "336-765-5221"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Colon and Rectal Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group, LLC (Novant Health Primary Care)
• Novant Health Medical Group, LLC (Novant Health Surgical Wellness)
• Novant Health Thomasville Medical Center, LLC (Novant Health Infusion)
• Novant Medical Group (Novant Health Nutrition Solutions)
• Novant Medical Group Inc (Novant Health Nutrition Solutions)
• Novant Medical Group Inc (Novant Health Triad Surgical Associates)
• Novant Medical Group, Inc (Novant Health Orthopedics & Sports Medicine)
• Novant Medical Group, Inc. (Novant Health Transitional Care & Infusion)
• Alexis Lamar Nowell, PT, DPT
• Allison O'Brien, BCBA

• Colon & Rectal Surgery Physician in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Colon & Rectal Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.