NOVANT HEALTH MEDICAL GROUP LLC NPI 1871527762

NPI Information

  • NPI: 1871527762
  • Provider Name: NOVANT HEALTH MEDICAL GROUP, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: NOVANT HEALTH WAVERLY PEDIATRICS AND PRIMARY CARE
  • Address: 11840 SOUTHMORE DR
    SUITE 200
    CHARLOTTE, NC
    ZIP 28277
  • Phone: (704) 384-1166

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NPI Details

NOVANT HEALTH MEDICAL GROUP, LLC 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 HEALTH MEDICAL GROUP, LLC NPI is 1871527762. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Waverly Pediatrics And Primary Care.

The provider's business location address is:

11840 SOUTHMORE DR
SUITE 200
CHARLOTTE, NC
ZIP 28277-466
Phone: (704) 384-1166
Fax: (704) 384-1181

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 enumeration date for this NPI number is 7/10/2006 and was last updated on 6/21/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNORTH CAROLINAYes
2207R00000XInternal MedicineNORTH CAROLINANo
3208000000XPediatricsNORTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15901214MEDICAIDNORTH CAROLINA
2CC5118OTHERNORTH CAROLINARAILROAD MEDICARE
3016XUOTHERNORTH CAROLINABCBS-NC
4NPB256MEDICAIDSOUTH CAROLINA

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: 3/30/2025

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