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NOVANT HEALTH SOUTHEAST OB/GYN
NPI 1063753325
Obstetrics & Gynecology in Matthews, NC

Active since March 12, 2013CLIA Certified · 2 labs
1450 MATTHEWS TOWNSHIP PKWY, SUITE 300, MATTHEWS, NC 28105(704) 321-1077(704) 321-1086 Get Directions Write a Review

NPPES record last updated: June 21, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 21, 2024, Jul 12, 2023, Aug 16, 2021 (3 updates tracked since 2021).

About Novant Health Southeast Ob/gyn NPPES

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

NOVANT HEALTH SOUTHEAST OB/GYN (NPI 1063753325) is a healthcare organization registered as an obstetrics & gynecology in Matthews, North Carolina and active in the NPI registry since March 2013. The organization holds 2 active CLIA laboratory certificates and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1063753325
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address1450 MATTHEWS TOWNSHIP PKWY, SUITE 300Matthews, NC 28105-2387
Mailing AddressPo Box 602362Charlotte, NC 28260-2362 · (704) 321-1077
Phone(704) 321-1077
Fax(704) 321-1086
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateMarch 12, 2013
Last NPPES UpdateJune 21, 20243 updates tracked since enumeration
NPPES CertifiedJune 21, 2024
✔ NPI 1063753325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1450 MATTHEWS TOWNSHIP PKWY, Matthews, NC 28105
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Other Names 1

Doing Business AsNovant Health Southeast Ob/gyn

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 for Provider-Performed Microscopy Procedures (PPMP) 34D0983848

Novant Health Southeast Ob/Gyn · Matthews, NC
Active · expires Mar 6, 2027
CLIA Number34D0983848
Laboratory TypePhysician Office
Certificate Effective DateMarch 7, 2025
Certificate Expiration DateMarch 6, 2027
Laboratory DirectorPeter Salib
Laboratory Phone(704) 321-1077
Laboratory LocationNovant Health Southeast Ob/Gyn1450 Matthews Township Pkwy Suite 300, Matthews, NC 28105
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 34D2345241

Novant Health Elizabeth Ob/Gyn · Matthews, NC
Active · expires Jun 7, 2028
CLIA Number34D2345241
Laboratory TypePhysician Office
Certificate Effective DateJune 8, 2026
Certificate Expiration DateJune 7, 2028
Laboratory DirectorTodd Jenkins
Laboratory Phone(704) 316-6860
Laboratory LocationNovant Health Elizabeth Ob/Gyn1450 Matthews Township Pkwy, Ste 300, Matthews, NC 28105
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

ORTHOCAROLINA PA
Orthopaedic Surgery
1450 MATTHEWS TOWNSHIP PKWY, SUITE 150
MATTHEWS, NC 28105
Mecklenburg County (704) 323-3200
DR. DAVID LOWELL BECKER M.D.
Family Medicine
1450 MATTHEWS TOWNSHIP PKWY, SUITE 450
MATTHEWS, NC 28105
Mecklenburg County (704) 384-8480
ORTHOCAROLINA, PA
Orthopaedic Surgery
1450 MATTHEWS TOWNSHIP PKWY, SUITE 150
MATTHEWS, NC 28105
Mecklenburg County (704) 323-2000
ZACHARY ALAN SHANITKVICH
Obstetrics & Gynecology
1450 MATTHEWS TOWNSHIP PKWY
MATTHEWS, NC 28105
Mecklenburg County (704) 246-1846
NOVANT MEDICAL GROUP, INC.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
1450 MATTHEWS TOWNSHIP PKWY, SUITE 410
MATTHEWS, NC 28105
Mecklenburg County (704) 384-7680
DR. MICHAEL FRANCIS SWEENEY MD
Obstetrics & Gynecology
1450 MATTHEWS TOWNSHIP PKWY, SUITE 200
MATTHEWS, NC 28105
Mecklenburg County (704) 246-1846
JEANINE RENEE RUSSMAN DPT
Physical Therapist
1450 MATTHEWS TOWNSHIP PKWY, SUITE 120
MATTHEWS, NC 28105
Mecklenburg County (704) 323-3208
SUZANNE LAKE CCC-SLP
Speech-Language Pathologist
1450 MATTHEWS TOWNSHIP PKWY, SUITE 150
MATTHEWS, NC 28105
Mecklenburg County (704) 384-6631

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 1063753325. It was assigned to this organization in the NPPES registry on March 12, 2013. The provider is doing business as Novant Health Southeast Ob/Gyn.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 1450 Matthews Township Pkwy Suite 300, Matthews, NC 28105. The listed phone number is (704) 321-1077.

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

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

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 21, 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.