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NOVANT MEDICAL GROUP INC NPI 1912447079


NPI Information

NPI: 1912447079
Provider Name: NOVANT MEDICAL GROUP INC

Doing Business As: NOVANT HEALTH PRIMARY CARE SOUTH END

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D2129916

Address:
2400 SOUTH BLVD STE 103
CHARLOTTE, NC
ZIP 28203
Phone: (704) 316-3017
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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 1912447079. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Primary Care South End.

The provider's business location address is:

2400 SOUTH BLVD STE 103
CHARLOTTE, NC
ZIP 28203-773
Phone: (704) 316-3017
Fax: (704) 316-3018

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 34D2129916 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2017 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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