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NOVANT MEDICAL GROUP INC. NPI 1043340557


NPI Information

NPI: 1043340557
Provider Name: NOVANT MEDICAL GROUP, INC.

Doing Business As: NOVANT HEALTH BLAKENEY FAMILY PHYSICIANS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D1066904

Address:
5815 BLAKENEY PARK DR STE 200B
CHARLOTTE, NC
ZIP 28277
Phone: (704) 316-5080
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NOVANT MEDICAL GROUP, INC. is a family medicine in Charlotte, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NOVANT MEDICAL GROUP, INC. NPI is 1043340557. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Blakeney Family Physicians.

The provider's business location address is:

5815 BLAKENEY PARK DR STE 200B
CHARLOTTE, NC
ZIP 28277-734
Phone: (704) 316-5080
Fax: (704) 316-5085

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 34D1066904 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/6/2007 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNORTH 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
1019C1OTHERNORTH CAROLINABCBS-NC
25906264MEDICAIDNORTH 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: 4/28/2024

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