Novant Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Practice address

7110 Wrightsville Ave
Suite B4
Wilmington, NC 28403-7219

Phone

(910) 256-2877

Fax

(910) 256-2928

NPI assigned

Jan 11, 2006

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 identifiers 2

Other names 1

• Azalea Coast Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John D Irvin, MD

  • Family Medicine Physician
  • Southport, NC
  • NPI 1043207749

  Family Medicine

  NPD (past)
• Lloyd Jeff Taylor, PA

  • Physician Assistant
  • Salisbury, NC
  • NPI 1932155629
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212883200000",
    "number": "1750360467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 WRIGHTSVILLE AVE",
            "address_2": "SUITE B4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284037219",
            "telephone_number": "910-256-2877",
            "fax_number": "910-256-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 WRIGHTSVILLE AVE",
            "address_2": "SUITE B4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284037219",
            "telephone_number": "910-256-2877",
            "fax_number": "910-256-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2008-06-08",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906521",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "019F6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Azalea Coast Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health New Hanover Regional Medical Center LLC
• Novant Health New Hanover Regional Medical Center LLC
• Novant Health Wilmington Endoscopy Center LLC
• Novant Medical Group Inc
• Novant Medical Group, Inc.
• Susan Gail Novello, L.P.C.
• Pamela Novosel, MD
• Timothy James Novosel, MD
• Tracy A Novosel, MD
• Nuelife Health Systems

• All providers in Wilmington, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.