NPIMap

Organization Active NPI

Novant Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1780697474
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NOVANT MEDICAL GROUP, INC.
Practice address
1718 E 4TH St
Suite 201
Charlotte, NC 28204-3261
Phone
(704) 384-0560
Fax
(704) 384-0561
NPI assigned
Aug 14, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dinesh S Pai
Title
VP of Operations
Phone
(704) 384-9104

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060828000304 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 106 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salisbury, NC; Matthews, NC; Locust, NC; Durham, NC; Concord, NC; Charlotte, NC

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1718 E 4TH St
Suite 201
Charlotte, NC 28204-3261

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
5903763MedicaidNC
017Y0OtherNCBCBS

Other names 1

NPPES NPI Registry
  • Presbyterian Women's Health Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 15, 2009.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1780697474",
    "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",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043261",
            "telephone_number": "704-384-0560",
            "fax_number": "704-384-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2009-01-15",
        "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": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903763",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "017Y0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Women's Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.