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NOVANT MEDICAL GROUP INC. NPI 1013969674


NPI Information

NPI: 1013969674
Provider Name: NOVANT MEDICAL GROUP, INC.

Doing Business As: NOVANT HEALTH GILEAD ROAD PEDIATRICS & INTERNAL MEDICINE

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 34D1039753

Address:
9615 KINCEY AVENUE
SUITE 100
HUNTERSVILLE, NC
ZIP 28078
Phone: (704) 316-5635
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NOVANT MEDICAL GROUP, INC. is a pediatrics in Huntersville, 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 1013969674. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Gilead Road Pediatrics & Internal Medicine.

The provider's business location address is:

9615 KINCEY AVENUE
SUITE 100
HUNTERSVILLE, NC
ZIP 28078-140
Phone: (704) 316-5635
Fax: (704) 316-5640

The provider's authorized official is Leea Jeanine Walton .
The authorized official title is Rcs Manager and has the following contact phone number (704) 316-6081.

The CLIA number assigned to this NPI record is 34D1039753 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 7/10/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNORTH CAROLINANo
2208000000XPediatricsNORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1017F5OTHERNORTH CAROLINABCBS-NC
25902021MEDICAIDNORTH CAROLINA
3CC5118OTHERNORTH CAROLINARAILROAD MEDICARE

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: 5/5/2024

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