Provider Type Icon

NOVANT MEDICAL GROUP INC NPI 1366409492


NPI Information

NPI: 1366409492
Provider Name: NOVANT MEDICAL GROUP, INC

Doing Business As: NOVANT HEALTH PEDIATRIC NEUROLOGY & SLEEP

Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Organization

Specialization: Neurology with Special Qualifications in Child Neurology

Address:
1900 RANDOLPH ROAD
SUITE 1010
CHARLOTTE, NC
ZIP 28207
Phone: (704) 384-1390
Get Directions

NOVANT MEDICAL GROUP, INC is a neurology with special qualifications in child neurology psychiatry neurology in Charlotte, NC. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. NOVANT MEDICAL GROUP, INC NPI is 1366409492. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Pediatric Neurology & Sleep.

The provider's business location address is:

1900 RANDOLPH ROAD
SUITE 1010
CHARLOTTE, NC
ZIP 28207-117
Phone: (704) 384-1390
Fax: (704) 384-1063

The provider's authorized official is Shala Davis .
The authorized official title is Rcs Manager and has the following contact phone number (704) 303-7517.

The enumeration date for this NPI number is 5/1/2006 and was last updated on 8/16/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0008XPediatricsNeurodevelopmental DisabilitiesNORTH CAROLINANo
22084N0600XPsychiatry & NeurologyClinical NeurophysiologyNo
32084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1NPB151MEDICAIDSOUTH CAROLINA
2017U7OTHERNORTH CAROLINABCBS NC
35902989MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.