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NOVANT HEALTH BALLANTYNE PEDIATRICS
NPI 1184679359
Pediatrics in Charlotte, NC

Active since May 24, 2006CLIA 34D1046455 · Certificate of Compliance
14215 BALLANTYNE CORPORATE PL, SUITE 130, CHARLOTTE, NC 28277(704) 384-1950(704) 384-1955 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

About Novant Health Ballantyne Pediatrics NPPES

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

NOVANT HEALTH BALLANTYNE PEDIATRICS (NPI 1184679359) is a healthcare organization registered as a pediatrics in Charlotte, North Carolina and active in the NPI registry since May 2006. The organization holds a CLIA Certificate of Compliance certificate valid through May 19, 2028 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1184679359
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address14215 BALLANTYNE CORPORATE PL, SUITE 130Charlotte, NC 28277-3671
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-7283 · Fax (704) 316-0508
Phone(704) 384-1950
Fax(704) 384-1955
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateMay 24, 2006
Last NPPES UpdateJune 20, 20243 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
✔ NPI 1184679359 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.
14215 BALLANTYNE CORPORATE PL, Charlotte, NC 28277
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Other Names 1

Doing Business AsNovant Health Ballantyne Pediatrics

Other Identifiers 3

Medicaid89014UFNC
Other014UFNC · Bcbs Nc
MedicaidNPB265SC

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

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 34D1046455

Novant Health Ballantyne Pediatrics · Charlotte, NC
Active · expires May 19, 2028
CLIA Number34D1046455
Laboratory TypePhysician Office
Certificate Effective DateMay 20, 2026
Certificate Expiration DateMay 19, 2028
Laboratory DirectorMark S. Reynolds
Laboratory Phone(704) 384-1950
Laboratory LocationNovant Health Ballantyne Pediatrics14215 Ballantyne Corporate Place, Suite 130, Charlotte, NC 28277
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.

Other Providers at the Same Location NPPES 8

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

LISA M. DELACRUZ PNP
Nurse Practitioner
14215 BALLANTYNE CORPORATE PL, SUITE 130
CHARLOTTE, NC 28277
Mecklenburg County (704) 384-1950
JACKSONVILLE DIAGNOSTIC IMAGING LLC
Radiology (Diagnostic Radiology)
14215 BALLANTYNE CORPORATE PL
CHARLOTTE, NC 28277
Mecklenburg County (704) 384-1890
MRS. ELIZABETH ANN BARTIS NP
Nurse Practitioner
14215 BALLANTYNE CORPORATE PL, SUITE 130
CHARLOTTE, NC 28277
Mecklenburg County (704) 384-1950
LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
14215 BALLANTYNE CORPORATE PL, SUITE 110
CHARLOTTE, NC 28277
Mecklenburg County (704) 541-6117
NOVANT MEDICAL GROUP, INC
Internal Medicine (Sleep Medicine)
14215 BALLANTYNE CORPORATE PL, SUITE 240
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-5000
MS. SHARON MCVAY O'BRIEN PA-C
Physician Assistant
14215 BALLANTYNE CORPORATE PL, SUITE 230
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-5000
DR. KERRITH LYN JAECKEL M.D.
Pediatrics
14215 BALLANTYNE CORPORATE PL, SUITE 130
CHARLOTTE, NC 28277
Mecklenburg County (704) 384-1950
EMILY C CIOVACCO PA-C
Physician Assistant
14215 BALLANTYNE CORPORATE PL, SUITE 230
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-5000

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 1184679359. It was assigned to this organization in the NPPES registry on May 24, 2006. The provider is doing business as Novant Health Ballantyne Pediatrics.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 14215 Ballantyne Corporate Pl Suite 130, Charlotte, NC 28277. The listed phone number is (704) 384-1950.

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 a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 34D1046455) is associated with this NPI, valid through May 19, 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 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.