NOVANT HEALTH LAKESIDE PRIMARY CARE
NPI 1063771749
Family Medicine in Charlotte, NC
About Novant Health Lakeside Primary Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NOVANT HEALTH LAKESIDE PRIMARY CARE (NPI 1063771749) is a healthcare organization registered as a family medicine in Charlotte, North Carolina and active in the NPI registry since May 2012. The organization holds a CLIA Waiver certificate valid through May 5, 2028 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Novant Health Lakeside Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2,991Medicare enrollment records show 2,991 clinicians reassign Medicare billing to Novant Health Lakeside Primary Care, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 351 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 63
Nearest to this location (20)
See all 2,991Charlotte, NC 28262
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
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 Waiver 34D2048319
Novant Health Lakeside Primary Care - Brookdale · Charlotte, NCFrequently 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 1063771749. It was assigned to this organization in the NPPES registry on May 15, 2012. The provider is doing business as Novant Health Lakeside Primary Care.
Where is Novant Health Medical Group, LLC located?
Novant Health Medical Group, LLC is located at 13460 Plaza Road Ext Ste 100, Charlotte, NC 28215. The listed phone number is (704) 316-4990.
What is Novant Health Medical Group, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Novant Health Medical Group, LLC enrolled in Medicare?
Yes. Novant Health Medical Group, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Novant Health Medical Group, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2,991 clinicians in 63 Medicare specialties reassign their Medicare billing to Novant Health Medical Group, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (759), Family Practice (327) and Hospitalist (302). Of these, 7 practice at this address and 351 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Novant Health Medical Group, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2048319) is associated with this NPI, valid through May 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Novant Health Medical Group, LLC accept?
Health plans from Blue Cross and Blue Shield of NC and Cigna Healthcare 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 July 9, 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.
# Novant Health Lakeside Primary Care · NPI 1063771749
Family Medicine organization in Charlotte, North Carolina. Organization record, active in the CMS NPPES registry since May 15, 2012.
## Identity
- **NPI:** 1063771749 (Entity type: Organization)
- **Enumerated:** May 15, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Novant Health Medical Group, Llc
- **Organization subpart:** No
- **Authorized official:** Leea Walton, RCS MANAGER
## Practice location
- **Address:** 13460 PLAZA ROAD EXT STE 100, Charlotte, NC 28215-8923
- **Phone:** (704) 316-4990 · **Fax:** (704) 316-4998
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2,991 clinicians in 63 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (759), Family Practice (327), Hospitalist (302); 7 practice at this address and 351 within 10 miles; [full list](https://npiprofile.com/npi/1063771749/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2024
- **Other identifiers:** Medicaid 5921588 (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063771749) · Data from the CMS NPPES public registry.