Novant Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Practice address

1591 Yanceyville St
Suite 200
Greensboro, NC 27405-6941

Phone

(336) 232-0180

NPI assigned

Oct 10, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Geoffrey K Gardner

Title

VP of Finance

Phone

(704) 384-9094

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Medicine at Revolution Mill Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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

• Brian Kristian Cain, M.D.

  • Internal Medicine Physician
  • Concord, NC
  • NPI 1083733273
  NPD

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1770735508",
    "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": "704-384-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 YANCEYVILLE ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056941",
            "telephone_number": "336-232-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "704-384-9094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950463",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine at Revolution Mill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Medical Group Inc.
• Novant Medical Group, Inc
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group, Inc.
• Novant Medical Group. Inc
• Novir, LLC
• Diane Gates Nowack, RN

• Family Medicine Physician in Greensboro, NC
• Providers in Greensboro, 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 Mar 29, 2010; 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.