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NOVANT HEALTH CHILD & ADOLESCENT MEDICAL GROUP
NPI 1023062452
Pediatrics in Monroe, NC

Active since May 20, 2006CLIA Certified · 2 labs
1994 WELLNESS BLVD, SUITE 110, MONROE, NC 28110(704) 384-8460(704) 384-8465 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2024, Jul 10, 2023, Aug 16, 2021 (3 updates tracked since 2021).

About Novant Health Child & Adolescent Medical Group NPPES

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

NOVANT HEALTH CHILD & ADOLESCENT MEDICAL GROUP (NPI 1023062452) is a healthcare organization registered as a pediatrics in Monroe, North Carolina and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1023062452
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address1994 WELLNESS BLVD, SUITE 110Monroe, NC 28110-7768
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-8460 · Fax (704) 384-8465
Phone(704) 384-8460
Fax(704) 384-8465
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateMay 20, 2006
Last NPPES UpdateJune 20, 20243 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
✔ NPI 1023062452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1994 WELLNESS BLVD, Monroe, NC 28110
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Other Names 1

Doing Business AsNovant Health Child & Adolescent Medical Group

Other Identifiers 3

Medicaid5900603NC
Other017AFNC · Bcbs-nc
MedicaidNPB110SC

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 ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 34D1040796

Novant Health Child & Adolescent Medical Group Monroe · Monroe, NC
Active · expires Oct 3, 2027
CLIA Number34D1040796
Laboratory TypePhysician Office
Certificate Effective DateOctober 4, 2025
Certificate Expiration DateOctober 3, 2027
Laboratory DirectorLori Yanchik-Castro
Laboratory Phone(704) 384-8460
Laboratory LocationNovant Health Child & Adolescent Medical Group Monroe1994 Wellness Boulevard, Suite 110, Monroe, NC 28110
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 34D2104002

Novant Health Child & Adolescent Medical Group · Waxhaw, NC
Active · expires Oct 4, 2027
CLIA Number34D2104002
Laboratory TypePhysician Office
Certificate Effective DateOctober 5, 2025
Certificate Expiration DateOctober 4, 2027
Laboratory DirectorLori Yanchik-Castro
Laboratory Phone(704) 384-8460
Laboratory LocationNovant Health Child & Adolescent Medical Group3614 S Providence Road, Suite 101, Waxhaw, NC 28173
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

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

KELLI PENEGAR DUNCAN PA-C
Physician Assistant
1994 WELLNESS BLVD, SUITE 110
MONROE, NC 28110
Union County (704) 384-8460
MRS. JENNIFER P DEESE CPNP
Nurse Practitioner (Pediatrics)
1994 WELLNESS BLVD, SUITE 110
MONROE, NC 28110
Union County (704) 384-8460
DR. GARNET D MAHARAJH MD
Pediatrics
1994 WELLNESS BLVD, SUITE 110
MONROE, NC 28110
Union County (704) 384-8460
DR. DEBORAH QUEEN M.D.
Pediatrics
1994 WELLNESS BLVD, SUITE 110
MONROE, NC 28110
Union County (704) 384-8460
DR. GEORGE P THEVAOS M.D
Pediatrics
1994 WELLNESS BLVD, SUITE 110
MONROE, NC 28110
Union County (704) 384-8460
DR. LORI MICHELLE YANCHIK MD
Pediatrics
1994 WELLNESS BLVD, SUITE 110
MONROE, NC 28110
Union County (704) 384-8460

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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

The NPI number for Novant Health Medical Group, LLC is 1023062452. It was assigned to this organization in the NPPES registry on May 20, 2006. The provider is doing business as Novant Health Child & Adolescent Medical Group.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 1994 Wellness Blvd Suite 110, Monroe, NC 28110. The listed phone number is (704) 384-8460.

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

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Novant Health Medical Group, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Novant Health Medical Group, LLC accept?

Health plans from Blue Cross and Blue Shield of NC list Novant Health Medical Group, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Novant Health Medical Group, LLC was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.