NPIMap

Organization Active NPI

Novant Medical Group, Inc

Doing business as Novant Health Maternal-Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Cornelius, NC
National Provider Identifier
1770839458
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
NOVANT MEDICAL GROUP, INC
Doing business as
Novant Health Maternal-Fetal Medicine
Practice address
19475 Old Jetton Rd
Cornelius, NC 28031-6591
Phone
(704) 384-5701
Fax
(704) 384-5642
NPI assigned
Jul 31, 2012
Last updated
Aug 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Authorized official

Name
Shala Davis
Title
RCS Manager
Phone
(704) 303-7517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X NU Primary

Addresses

Primary practice location

19475 Old Jetton Rd
Cornelius, NC 28031-6591

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-5701

Other names 1

  • Novant Health Maternal-Fetal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000692 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 3,607 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Inpt Care503 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

19475 Old Jetton Rd
Cornelius, NC 28031
Phone (704) 316-1847

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1770839458",
    "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": "704-384-5701",
            "fax_number": "704-384-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19475 OLD JETTON RD",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316591",
            "telephone_number": "704-384-5701",
            "fax_number": "704-384-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Maternal-Fetal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Maternal-Fetal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.