NPIMap

Organization Active NPI

Novant Medical Group Inc

  • Family Medicine Physician
  • Gaffney, SC
National Provider Identifier
1891932919
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NOVANT MEDICAL GROUP INC
Doing business as
Novant Health Peachview Family Medicine
Practice address
722 Hyatt St
Suite C
Gaffney, SC 29341-2644
Phone
(864) 489-2400
Fax
(864) 489-7788
NPI assigned
Jan 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Authorized official

Name
Geoffrey K. Gardner
Title
VP Finance
Phone
(704) 384-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

722 Hyatt St
Suite C
Gaffney, SC 29341-2644

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (864) 489-2400

Other names 1

  • Novant Health Peachview Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061212000240 SC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 23 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Mill, SC; Indian Land, SC

Other NPIs on the same Medicare enrollment 37

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

View all 37

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1891932919",
    "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": "864-489-2400",
            "fax_number": "864-489-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 HYATT ST",
            "address_2": "SUITE C",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412644",
            "telephone_number": "864-489-2400",
            "fax_number": "864-489-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "704-384-9094"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Peachview Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.