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NOVANT HEALTH PROVIDENCE OB/GYN
NPI 1861520074
Obstetrics & Gynecology in Charlotte, NC

Active since March 01, 2007
1718 E 4TH ST, SUITE 907, CHARLOTTE, NC 28204(704) 372-4000(704) 334-4855 Get Directions Write a Review

NPPES record last updated: July 5, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Novant Health Providence Ob/gyn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVANT HEALTH PROVIDENCE OB/GYN (NPI 1861520074) is a healthcare organization registered as an obstetrics & gynecology in Charlotte, North Carolina and active in the NPI registry since March 2007. The organization lists Geoffrey K. Gardner, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1861520074
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameNOVANT MEDICAL GROUP, INC.
Location Address1718 E 4TH ST, SUITE 907Charlotte, NC 28204-3282
Mailing AddressPo Box 602362Charlotte, NC 28260-2362 · (704) 372-4000 · Fax (704) 334-4855
Phone(704) 372-4000
Fax(704) 334-4855
Organization SubpartNo
Authorized OfficialGeoffrey K. GardnerVp Of Finance · (704) 372-4000
Enumeration DateMarch 1, 2007
Last NPPES UpdateJuly 5, 2013
✔ NPI 1861520074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1718 E 4TH ST, Charlotte, NC 28204
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Other Names 1

Doing Business AsNovant Health Providence Ob/gyn

Other Identifiers 5

Medicare PIN2308634FNC
Other011VYNC · Bcbs Nc
Medicare PIN2308634NC
Medicaid5907955NC
MedicaidNPB255SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
1718 E 4TH ST, SUITE 707
CHARLOTTE, NC 28204
Mecklenburg County (704) 598-7320
DR. PHILIP WILLIAM DE HOFF M. D.
Obstetrics & Gynecology
1718 E 4TH ST, SUITE 907
CHARLOTTE, NC 28204
Mecklenburg County (704) 372-4000
STEPHANIE DAWN RITCHIE PA-C
Physician Assistant (Surgical)
1718 E 4TH ST, SUITE 701
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
NOVANT MEDICAL GROUP
Internal Medicine (Infectious Disease)
1718 E 4TH ST, SUITE 401
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-7840
JESSICA PUSKARICH NP
Nurse Practitioner
1718 E 4TH ST, SUITE 307
CHARLOTTE, NC 28204
Mecklenburg County (704) 333-1259
KAO NU LY PA-C
Physician Assistant (Surgical)
1718 E 4TH ST, SUITE 805
CHARLOTTE, NC 28204
Mecklenburg County (704) 376-5636
ROBERT BRIAN FAZIA MD
Internal Medicine (Cardiovascular Disease)
1718 E 4TH ST, SUITE 501
CHARLOTTE, NC 28204
Mecklenburg County (704) 343-9800
NOVANT HEALTH MEDICAL GROUP, LLC
Obstetrics & Gynecology
1718 E 4TH ST, SUITE 201
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-0560

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Novant Medical Group, Inc.'s NPI number?

The NPI number for Novant Medical Group, Inc. is 1861520074. It was assigned to this organization in the NPPES registry on March 1, 2007. The provider is doing business as Novant Health Providence Ob/Gyn.

Where is Novant Medical Group, Inc. located?

Novant Medical Group, Inc. is located at 1718 E 4th St Suite 907, Charlotte, NC 28204. The listed phone number is (704) 372-4000.

What is Novant Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Novant Medical Group, Inc. was last updated on July 5, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.