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NOVANT MEDICAL GROUP INC. NPI 1346548898


NPI Information

NPI: 1346548898
Provider Name: NOVANT MEDICAL GROUP INC.

Doing Business As: NOVANT HEALTH PROSPERITY FAMILY PHYSICIANS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D2021841

Address:
8420 UNIVERSITY EXEC PARK DR STE 850
CHARLOTTE, NC
ZIP 28262
Phone: (704) 384-1225
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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 1346548898. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Prosperity Family Physicians.

The provider's business location address is:

8420 UNIVERSITY EXEC PARK DR STE 850
CHARLOTTE, NC
ZIP 28262-308
Phone: (704) 384-1225
Fax: (704) 384-1226

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 34D2021841 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2011 and was last updated on 7/11/2023.


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 MedicineYes

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
15918729MEDICAIDNORTH 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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