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NOVANT MEDICAL GROUP INC. NPI 1790725299


NPI Information

NPI: 1790725299
Provider Name: NOVANT MEDICAL GROUP, INC.

Doing Business As: NOVANT HEALTH PEDIATRICS SOUTH BALLANTYNE

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 34D0688109

Address:
16139 LANCASTER HWY
SUITE 110
CHARLOTTE, NC
ZIP 28277
Phone: (704) 384-1440
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NOVANT MEDICAL GROUP, INC. is a pediatrics in Charlotte, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. NOVANT MEDICAL GROUP, INC. NPI is 1790725299. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Pediatrics South Ballantyne.

The provider's business location address is:

16139 LANCASTER HWY
SUITE 110
CHARLOTTE, NC
ZIP 28277-033
Phone: (704) 384-1440
Fax: (704) 384-1452

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 CLIA number assigned to this NPI record is 34D0688109 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2006 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
1208000000XPediatricsNORTH CAROLINAYes

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
189011JFMEDICAIDNORTH CAROLINA
2NPA897MEDICAIDSOUTH CAROLINA
3011JFOTHERNORTH CAROLINABCBS NC

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

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