NOVANT HEALTH MEDICAL GROUP, LLC
NPI 1003966185
Pediatrics - Pediatric Gastroenterology in Charlotte, NC

Q: What is Novant Health Medical Group, LLC's NPI number?

The NPI number for Novant Health Medical Group, LLC is 1003966185. It was assigned to this organization in the NPPES registry on January 11, 2007. The provider is doing business as Novant Health Pediatric Gastroenterology.

Q: What is Novant Health Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Active since January 11, 2007

1918 RANDOLPH RD STE 210, CHARLOTTE, NC 28207(704) 316-5060(704) 316-5069 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2024, Jul 11, 2023, Aug 16, 2021 (3 updates tracked since 2021).

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About Novant Health Medical Group, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVANT HEALTH MEDICAL GROUP, LLC (NPI 1003966185), doing business as Novant Health Pediatric Gastroenterology, is a healthcare organization registered as a pediatric gastroenterology in Charlotte, North Carolina and active in the NPI registry since January 2007. The organization maintains 2 additional practice locations and lists Leea Jeanine Walton, Edi Manager, as its authorized official.

NPPES Registry Identity

NPI1003966185

Entity TypeOrganization

Primary Taxonomy2080P0206X

Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC

Location Address1918 RANDOLPH RD STE 210Charlotte, NC 28207-1109

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 316-5060 · Fax (704) 316-5069

Phone(704) 316-5060

Fax(704) 316-5069

Organization SubpartNo

Authorized OfficialLeea Jeanine WaltonEdi Manager · (704) 316-6081

Enumeration DateJanuary 11, 2007

Last NPPES UpdateJuly 31, 20253 updates tracked since enumeration

NPPES CertifiedJuly 31, 2025

✔ NPI 1003966185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0206X

Definition

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.

1918 RANDOLPH RD STE 210, Charlotte, NC 28207

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Other Names 1

Doing Business AsNovant Health Pediatric Gastroenterology

Secondary Practice Locations 2

Location 11401 Matthews Township Pkwy Ste 100Matthews, NC 28105-5403 · Phone (704) 316-5060 · Fax (704) 316-5069

Location 22711 Randolph Rd, Suite 301Charlotte, NC 28207-2027 · Phone (704) 316-5060 · Fax (704) 316-5069

Other Identifiers 3

Medicaid5905866NC

Other018WHNC · Bcbs Nc

MedicaidNPB219SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM STOKES HOUCK III M.D.

Pediatrics (Pediatric Gastroenterology)