Provider Type Icon

NOVANT MEDICAL GROUP INC NPI 1710051123


NPI Information

NPI: 1710051123
Provider Name: NOVANT MEDICAL GROUP INC

Doing Business As: NOVANT HEALTH OCEANSIDE FAMILY MEDICINE & CONVENIENT CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D2104873

Address:
5145 SELLERS RD
SUITE A
SHALLOTTE, NC
ZIP 28470
Phone: (910) 754-4441
Get Directions

NOVANT MEDICAL GROUP INC is a family medicine in Shallotte, 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 1710051123. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Oceanside Family Medicine & Convenient Care.

The provider's business location address is:

5145 SELLERS RD
SUITE A
SHALLOTTE, NC
ZIP 28470-405
Phone: (910) 754-4441
Fax: (910) 754-5307

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 34D2104873 - industrial with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2006 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15905786MEDICAIDNORTH CAROLINA
2018N9OTHERNORTH 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: 5/5/2024

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.