OrganizationActive
Novant Medical Group Inc
NPI 1104479708 · Developmental - Behavioral Pediatrics Physician · Concord, NC
Provider details
- NPI number
- 1104479708
- Entity type
- Organization
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Shala Davis, Managed Care Enrollment Manager(704) 316-7845
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
311 Coddle Market Dr Nw Ste 200
Concord, NC 28027-2432
Phone: (980) 302-9145
Fax: (704) 384-0568
Street-level locationGet directions
Mailing address
Po Box 60447
Charlotte, NC 28260-0447
Other names (DBA / former)
- Doing business as
- Novant Health Developmental &behavioral Pediatrics
Registry dates
- Enumerated
- 2019-07-23
- Last updated
- 2019-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.