Active NPI
Novant Medical Group Inc
Doing business as Novant Health Pediatric Neurology
- Neurology Physician
- Charlotte, NC
National Provider Identifier
1851772933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- Legal business name
- NOVANT MEDICAL GROUP INC
- Doing business as
- Novant Health Pediatric Neurology
- Practice address
- 8401 Medical Plaza Dr
Suite 220
Charlotte, NC 28262-8700 - Phone
- (704) 384-1390
- Fax
- (704) 384-1063
- NPI assigned
- Jun 15, 2015
- Last updated
- Jun 30, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Geoffrey K Gardner
- Title
- VP of Finance
- Phone
- (704) 384-1390
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | Primary |
Addresses
Primary practice location
8401 Medical Plaza Dr
Suite 220
Charlotte, NC 28262-8700
Mailing address
8401 Medical Plaza Dr
Suite 220
Charlotte, NC 28262-8700
Phone (704) 384-1390
Other names 1
- Novant Health Pediatric Neurology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryPractitioners & 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.
-
- Obstetrics & Gynecology Physician
- Charlotte, NC
- NPI 1013077072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1435622400000",
"number": "1851772933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 MEDICAL PLAZA DR",
"address_2": "SUITE 220",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282628700",
"telephone_number": "704-384-1390",
"fax_number": "704-384-1063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 MEDICAL PLAZA DR",
"address_2": "SUITE 220",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282628700",
"telephone_number": "704-384-1390",
"fax_number": "704-384-1063"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOVANT MEDICAL GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-15",
"last_updated": "2015-06-30",
"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": "704-384-1390"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Novant Health Pediatric Neurology",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Charlotte, NC
- Novant Medical Group Inc (Novant Health Sleep Center)
- Novant Medical Group Inc (Novant Health Sleep Center)
- Novant Medical Group Inc (Calabretta Cosmetic Surgery Center)
- Novant Medical Group Inc (NH Palliative Care)
- Novant Medical Group Inc (Novant Health Uptown Primary Care)
- Novant Medical Group Inc (Novant Health Cancer Specialist)
- Novant Medical Group Inc. (Novant Health Hepatobiliary & Pancreas Specialists)
- Novant Medical Group, Inc
- Novant Medical Group, Inc (Novant Health Developmental & Behavioral Pediatrics)
- Novant Medical Group, Inc (Novant Health Pulmonary & Critical Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.