Novant Medical Group, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

NOVANT MEDICAL GROUP, INC.

Doing business as

Novant Health Cancer Institute

Practice address

6324 Fairview Rd Ste 420
Charlotte, NC 28210-3372

Phone

(980) 302-8840

Fax

(980) 302-8865

NPI assigned

Dec 3, 2019

Last updated

Aug 18, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

NOVANT MEDICAL GROUP, INC.As reported in NPPES

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

Addresses

Other names 1

• Novant Health Cancer Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Presbyterian Inpt Care

Practitioners 2

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.

• Carrie E Bush, MSN, FNP

  • Nurse Practitioner
  • Huntersville, NC
  • NPI 1871920686
  NPD
• Meredith Was Kocher

  • Physician Assistant
  • Charlotte, NC
  • NPI 1154814572
  NPD

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1922645571",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103372",
            "telephone_number": "980-302-8840",
            "fax_number": "980-302-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVANT MEDICAL GROUP, INC.",
        "enumeration_date": "2019-12-03",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Medical Group, Inc. (Novant Health Gynecologic Oncology Associates)
• Novant Medical Group, Inc. (Novant Health Blume Pediatric Hematology & Oncology)
• Novant Medical Group, Inc. (Novant Health Primary Care Mint Hill)
• Novant Medical Group, Inc. (Novant Health Southeast OB/GYN)
• Novant Medical Group, Inc.
• Novant Medical Group, Inc. (Novant Health Palliative Care)
• Novant Medical Group, Inc. (Novant Health Northlake Dermatology)
• Novant Medical Group. Inc. (Novant Health University Family Physicians)
• Novaris Behavioral Health LLC
• Novastell Counseling, PLLC

• Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.