Active NPI
Novant Medical Group, Inc.
Doing business as Mid Carolina Cardiology
- Cardiovascular Disease Physician
- Monroe, NC
National Provider Identifier
1669609517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- NOVANT MEDICAL GROUP, INC.
- Doing business as
- Mid Carolina Cardiology
- Practice address
- 1640 E Roosevelt Blvd
Monroe, NC 28112-4017 - Phone
- (704) 226-0500
- Fax
- (704) 226-0599
- NPI assigned
- Jun 18, 2009
- Last updated
- Jul 19, 2011
- Organization subpart
- Yes
- Parent organization
- NOVANT MEDICAL GROUP, INC
NPPES NPI Registry
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
1640 E Roosevelt Blvd
Monroe, NC 28112-4017
Mailing address
PO Box 602362
Charlotte, NC 28260-2362
Phone (704) 343-7784
Other names 1
- Mid Carolina Cardiology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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- Part of
- Presbyterian Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1311033600000",
"number": "1669609517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602362",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282602362",
"telephone_number": "704-343-7784",
"fax_number": "704-347-7830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 E ROOSEVELT BLVD",
"city": "MONROE",
"state": "NC",
"postal_code": "281124017",
"telephone_number": "704-226-0500",
"fax_number": "704-226-0599"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOVANT MEDICAL GROUP, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NOVANT MEDICAL GROUP, INC",
"enumeration_date": "2009-06-18",
"last_updated": "2011-07-19",
"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": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mid Carolina Cardiology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Monroe, NC
- Novant Medical Group Inc (Novant Health Sleep Center)
- Novant Medical Group Inc (Novant Health Pulmonary and Critical Care)
- Novant Medical Group, Inc (Total Spine Specialists)
- Novant Medical Group, Inc. (Center for Child & Adolescent Medicine-Monroe)
- Novant Medical Group, Inc. (Rocky River Family Physicians)
- Novant Medical Group. Inc (Novant Health Gynecologic Oncology Associates)
- Susan E Nowak, PT
- Nurturing Hands Home Care LLC
- Drew Lewis Nutter, CPO
- Kylee Nutter, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.