NOVANT HEALTH MEDICAL GROUP, LLC – NPI #1003966185
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.

NOVANT HEALTH MEDICAL GROUP, LLC is a provider located in CHARLOTTE, NC. NPPES has assigned the NPI number 1003966185 to NOVANT HEALTH MEDICAL GROUP, LLC on January 11, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. 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 last updated on Jul 31, 2025. 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 NOVANT HEALTH MEDICAL GROUP, LLC below.

NPI Profile for
NOVANT HEALTH MEDICAL GROUP, LLC

NPI Number
1003966185
Enumeration Date

(more than 19 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 HEALTH MEDICAL GROUP, LLC
Primary location
1918 RANDOLPH RD STE 210
CHARLOTTE, NC 28207-1109
Phone: (704) 316-5060 Fax: (704) 316-5069
2 Other location(s):
2711 Randolph Rd
Suite 301
Charlotte, NC 28207-2027
Phone: (704) 316-5060
Fax: (704) 316-5069
1401 Matthews Township Pkwy Ste 100
Matthews, NC 28105-5403
Phone: (704) 316-5060
Fax: (704) 316-5069
Mailing address
PO BOX 60447
CHARLOTTE, NC 28260-0447
Phone: (704) 316-5060 Fax: (704) 316-5069
Organization Subpart
No
Authorized Official
LEEA WALTON
EDI MANAGER
Phone: (704) 316-6081
Updated
Certification Date
Jul 31, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NOVANT HEALTH MEDICAL GROUP, LLC

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
otherBCBS NCNC018WH
medicaidNC5905866
medicaidSCNPB219
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)
NC

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.