PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE) – NPI #1164705653
Pediatrics

A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE) is a provider located in CHARLOTTE, NC. NPPES has assigned the NPI number 1164705653 to PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE) on September 21, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE)” is a dba name, the actual legal business name for this organization is NOVANT MEDICAL GROUP INC. The primary taxonomy selected by this provider is 2080P0206X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Pediatric Gastroenterology

The NPI profile was previously updated about 10 years ago on Sep 29, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE) below.

NPI Profile for
NOVANT MEDICAL GROUP INC

NPI Number
1164705653
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NOVANT MEDICAL GROUP INC
Doing Business As (dba): PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE)
Primary location
16139 LANCASTER HWY
SUITE 110
CHARLOTTE, NC 28277-2033
Phone: (704) 316-5060 Fax: (704) 316-5069
Mailing address
P O BOX 60447
NOVANT MEDICAL GROUP, INC.
CHARLOTTE, NC 28275-1803
Phone: (704) 316-5060 Fax: (704) 316-5069
Organization Subpart
No
Authorized Official
GEOFFREY GARDNER
VP FINANCE NMG
Phone: (704) 384-9094
Updated
Identifiers

Identifiers for PEDIATRIC GASTROENTEROLOGY ASSOCIATES (SATELLITE)

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNC5919443
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080P0206X
- Pediatrics / Pediatric Gastroenterology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.