Novant Medical Group, Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

NOVANT MEDICAL GROUP, INC

Practice address

205 Sandalwood Ave
Suite B
Louisburg, NC 27549-2679

Phone

(919) 496-1050

Fax

(919) 496-0191

NPI assigned

Dec 6, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Geoffrey Gardner

Title

VP Finance

Phone

(919) 496-1050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Novant Health Franklin General & Vascular Surgery 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": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1740583228",
    "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": "919-496-1050",
            "fax_number": "919-496-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SANDALWOOD AVE",
            "address_2": "SUITE B",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492679",
            "telephone_number": "919-496-1050",
            "fax_number": "919-496-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "919-496-1050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916289",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Franklin General & Vascular Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Carolina Em-I Medical Services PC
• North Carolina Surgical Associates, PLLC
• Novant Medical Group Inc
• Novant Medical Group Inc
• Novant Medical Group Inc
• Novant Medical Group, Inc.
• Michael Andre Nustar
• Joyce Ekwutosi Ogbu
• Shiffon P Oliver, CRC, LCMHCA
• Kennedy U. Onori, PHD., FNP-BC

• Surgery Physician in Louisburg, NC
• Providers in Louisburg, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.