Novant Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP

Doing business as

Cooleemee Family Practice

Practice address

143 Marginal Street
Cooleemee, NC 27014-0910

Phone

(336) 284-2331

NPI assigned

Aug 28, 2008

Last updated

Sep 21, 2009By 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 Pai

Title

VP of Operations

Phone

(704) 384-9104

Specialties & licenses 1

Addresses

Other names 1

• Cooleemee Family Practice 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": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1669620910",
    "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": "336-284-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 MARGINAL STREET",
            "city": "COOLEEMEE",
            "state": "NC",
            "postal_code": "270140910",
            "telephone_number": "336-284-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "PAI",
        "authorized_official_first_name": "DINESH",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "704-384-9104"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooleemee Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tangela Dalton, CNA1 MED AIDE
• Charles Eubie Evans Jr., RPH
• Gaston Family Health Services, Inc. (Kintegra at Cooleemee Elementary)
• Brittany Hall, LCMHC
• Kevin Chavez DMD - Cooleemee, PLLC
• Jaydeep K Patel
• Rowan Diagnostic Clinic
• Rowan Medical Practice (Cooleemee Family Practice)
• S&G Drugs LLC (Davie Discount Drugs)

• Family Medicine Physician in Cooleemee, NC
• Providers in Cooleemee, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.