# NOVANT MEDICAL GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NOVANT MEDICAL GROUP, INC.
- **Other names:** Novant Health Diabetes & Nutrition
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407491905
- **Legal business name:** NOVANT MEDICAL GROUP, INC.
- **Authorized official:** SHALA DAVIS (ENROLLMENT MANAGER)
- **Authorized official phone:** (704) 316-7845

## Contact information

- **Practice address:** 11300 CRESTHILL DR STE 100, MINT HILL, NC 28227-7924
- **Practice address phone:** (980) 302-8500
- **Practice address fax:** (980) 302-8501
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | Yes |
| 133NN1002X | Nutrition Education Nutritionist | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2019
- **Last updated:** 02/13/2020