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Contact Information

NOVANT HEALTH MEDICAL GROUP, LLC
1918 RANDOLPH RD STE 700
CHARLOTTE, NC28207-1167
 Phone: 704-316-1220
 Fax: 704-316-1230
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for NOVANT HEALTH MEDICAL GROUP, LLC

NPI Number 1265488407
LBN Legal business name NOVANT HEALTH MEDICAL GROUP, LLC
Authorized official LEEA WALTON - (RCS MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/26/2006
Last updated 06/14/2024 - More than a year ago
Identifiers
NC Medicaid 5900388
SC Medicaid NPB105
NC Other 016XK BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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