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 Delco

Practice address

25805 Andrew Jackson Highway E
Delco, NC 28436-8916

Phone

(910) 655-9900

Fax

(910) 655-9907

NPI assigned

Sep 13, 2007

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 2

Other names 1

• Novant Urgent Care Delco 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": "1219017600000",
    "number": "1699960468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25805 ANDREW JACKSON HWY E",
            "city": "DELCO",
            "state": "NC",
            "postal_code": "284368916",
            "telephone_number": "910-655-9900",
            "fax_number": "910-655-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25805 ANDREW JACKSON HIGHWAY E",
            "city": "DELCO",
            "state": "NC",
            "postal_code": "284368916",
            "telephone_number": "910-655-9900",
            "fax_number": "910-655-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2008-08-18",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908607",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "019V8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Urgent Care Delco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urgent Care Clinic/Center in Delco, NC
• Providers in Delco, 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 Aug 18, 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.