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NOVANT MEDICAL GROUP INC. NPI 1861019150


NPI Information

NPI: 1861019150
Provider Name: NOVANT MEDICAL GROUP, INC.

Doing Business As: NOVANT HEALTH MICHAEL JORDAN FAMILY MEDICAL CLINIC - NORTH END

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D2192072

Address:
2701 STATESVILLE AVE.
CHARLOTTE, NC
ZIP 28206
Phone: (980) 302-8521
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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 1861019150. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Michael Jordan Family Medical Clinic - North End.

The provider's business location address is:

2701 STATESVILLE AVE.
CHARLOTTE, NC
ZIP 28206
Phone: (980) 302-8521
Fax: (980) 302-8525

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 34D2192072 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/2/2020 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

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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