Novant Medical Group, Inc.
Organization Active NPI Cardiovascular Disease Physician · Southport, NC
NPI 1679528384 · NPPES record last updated Jun 8, 2008
Key facts
- NPI
- 1679528384
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- NOVANT MEDICAL GROUP, INC.
- Practice address
- 1029 N Howe St
Suite 100B
Southport, NC 28461-3039 - Phone
- (910) 457-9081
- Fax
- (910) 457-9083
- NPI assigned
- May 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Dinesh S Pai
- Title
- VP of Operations
- Phone
- (704) 384-9104
Other NPIs on the same Medicare enrollment 19
Practitioners 89
-
Linda Agyapong, M.D.
-
Asaad Elsayed Ahmed, M.D.
-
Amy Lowery Alexanian, M.D.
-
Aram Alexanian, M.D.
-
Lori Ann Andrews, APRN
-
Suima Aryal, MD
-
Charles Jasper Atkinson, M.D.
-
Candace Anjanee Boone, FNP-BC
-
Angela Mary Brady-Fleming, FNP-C
-
Carrie E Bush, MSN, FNP
-
Brian Kristian Cain, M.D.
-
Kate Leslye Campbell, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060828000304 | NC | Part B Supplier - Clinic/Group Practice | 1153234893 |
Receives reassigned benefits from 106 practitioners 19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Salisbury, NC; Matthews, NC; Locust, NC; Durham, NC; Concord, NC; Charlotte, NC |
National Provider Directory
Locations
1029 N Howe St
Ste 100B
Southport, NC 28461
Phone (910) 457-9081
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | NC | Yes |
Addresses
Primary practice location
1029 N Howe St
Suite 100B
Southport, NC 28461-3039
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5903444 | Medicaid | NC | |
| 017YN | Other | NC | BCBS |
Other names
- Heart Specialists of Brunswick
Other providers in Southport, NC
- Novant Health Medical Group, LLC
- Novant Medical Group Inc
- Novant Medical Group, Inc.
- Novant Medical Group, Inc.
- Novant Medical Group, Inc.
- Novant Medical Group, Inc.
- Edgar E Null
- O.T. Center Inc.
- John Cameron O'Brien Jr.
- Oak Island Pediatrics, P.a.
All providers in Southport, NC · Cardiovascular Disease Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.