NOVANT HEALTH MEDICAL GROUP LLC
NPI 1205884970
Obstetrics & Gynecology in Bolivia, NC

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

The NPI number for Novant Health Medical Group LLC is 1205884970. It was assigned to this organization in the NPPES registry on May 5, 2006. The provider is doing business as Novant Health Brunswick Ob/Gyn & Midwifery and Novant Health OB/GYN.

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

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

Active since May 05, 2006

584 HOSPITAL DR NE UNIT B, BOLIVIA, NC 28422(910) 721-4050(910) 721-4051 Get Directions Write a Review

NPPES record last updated: March 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 12, 2025, Jun 20, 2024, Jul 11, 2023 and 4 more (7 updates tracked since 2019).

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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 1205884970), doing business as Novant Health Brunswick Ob/gyn & Midwifery, is a healthcare organization registered as an obstetrics & gynecology in Bolivia, North Carolina and active in the NPI registry since May 2006. The organization maintains 3 additional practice locations and lists Leea Jeanine Walton, Edi Manager, as its authorized official.

NPPES Registry Identity

NPI1205884970

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NameNOVANT HEALTH MEDICAL GROUP LLC

Location Address584 HOSPITAL DR NE UNIT BBolivia, NC 28422-0020

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (910) 721-4050

Phone(910) 721-4050

Fax(910) 721-4051

Organization SubpartNo

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

Enumeration DateMay 5, 2006

Last NPPES UpdateMarch 12, 20257 updates tracked since enumeration

NPPES CertifiedMarch 12, 2025

✔ NPI 1205884970 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.

584 HOSPITAL DR NE UNIT B, Bolivia, NC 28422

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Other Names 2

Doing Business AsNovant Health Brunswick Ob/gyn & Midwifery

Doing Business AsNovant Health Ob/gyn

Secondary Practice Locations 3

Location 11456 N Howe St Ste 201Southport, NC 28461-2674 · Phone (910) 721-4050 · Fax (910) 721-4051

Location 2509 Olde Waterford Way Ste 200Leland, NC 28451-4126 · Phone (910) 721-4050 · Fax (910) 721-4051

Location 375 Emerson Bay Rd Ste 104Carolina Shores, NC 28467-2498 · Phone (910) 721-4050 · Fax (910) 721-4051

Other Identifiers 1

Medicaid5903335NC

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 Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.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 Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2,991

Medicare enrollment records show 2,991 clinicians reassign Medicare billing to Novant Health Medical Group LLC, which bills Medicare for the services they deliver. Of these, 17 practice at this address and 79 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 63

Nurse Practitioner759

Family Practice327

Hospitalist302

Pediatric Medicine233

Obstetrics/Gynecology187

Internal Medicine178

Neurology150

Cardiovascular Disease (Cardiology)94

55 other specialties761

Nearest to this location (20)

See all 2,991

Austin Anzivino, DO

Obstetrics/Gynecology

NPI 1972185775

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Megan Childres, FNP

Nurse Practitioner

NPI 1881155034

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Thao Nguyen

Obstetrics/Gynecology

NPI 1679152052

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Michele Polidoro, MD

Obstetrics/Gynecology

NPI 1780652909

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOSSame address

Nicole Rose Cervantes, CNM

Certified Nurse Midwife (CNM)

NPI 1528720729

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOSSame address

Shea Stewart, CNM

Certified Nurse Midwife (CNM)

NPI 1912792607

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Richard Thompson, DO

Obstetrics/Gynecology

NPI 1902125131

584 HOSPITAL DR NE SUITE B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Jessica Bentley, CNM

Certified Nurse Midwife (CNM)

NPI 1194222869

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Nicholas Bodenheimer, DO

Obstetrics/Gynecology

NPI 1457642134

584 HOSPITAL DRIVE SUITE B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Elizabeth Desandre, NP

Nurse Practitioner

NPI 1821678368

584 HOSPITAL DR NE UNIT D
Bolivia, NC 28422

(910) 721-4150

✔ PECOS✔ Accepts MedicareSame address

Sarah Koenigseker, CNM

Certified Nurse Midwife (CNM)

NPI 1528513223

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOSSame address

Lydia Laboccetta

Urology

NPI 1477716280

584 HOSPITAL DR NE UNIT D
Bolivia, NC 28422

(910) 721-4150

✔ PECOS✔ Accepts MedicareSame address

Tracey Mccarthy, DO

Obstetrics/Gynecology

NPI 1679731822

584 HOSPITAL DR SUITE B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Steven Nunns, M.D.

General Practice

NPI 1134583768

584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Steven Robbins, MD

Urology

NPI 1710919006

584 HOSPITAL DR NE UNIT D
Bolivia, NC 28422

(910) 721-4150

✔ PECOS✔ Accepts MedicareSame address

Sara Brown, NP

Nurse Practitioner

NPI 1629008149

584 HOSPITAL DR NE STE. B
Bolivia, NC 28422

(910) 721-4050

✔ PECOS✔ Accepts MedicareSame address

Emily Lineberger, CNM, WHNP

Certified Nurse Midwife (CNM)

NPI 1205692365

584 HOSPITAL DR SUITE B
Bolivia, NC 28422

(630) 740-6161

✔ PECOSSame address

Nancy Desillier, RN

Nurse Practitioner

NPI 1104524271

257 HOSPITAL DR NE STE 100
Bolivia, NC 28422

(910) 721-4150

✔ PECOS✔ Accepts Medicare0.1 mi

Breanna Durbin, MD

General Surgery

NPI 1023570629

257 HOSPITAL DR NE STE 200
Bolivia, NC 28422

(910) 721-4000

✔ PECOS✔ Accepts Medicare0.1 mi

Erin Wallace

Internal Medicine

NPI 1326622333

257 HOSPITAL DR NE STE 101
Bolivia, NC 28422

(910) 721-4100

✔ PECOS✔ Accepts Medicare0.1 mi

See all 2,991 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 1205884970. It was assigned to this organization in the NPPES registry on May 5, 2006. The provider is doing business as Novant Health Brunswick Ob/Gyn & Midwifery and Novant Health OB/GYN.

Where is Novant Health Medical Group LLC located?

Novant Health Medical Group LLC is located at 584 Hospital Dr NE Unit B, Bolivia, NC 28422. The listed phone number is (910) 721-4050.

What is Novant Health Medical Group LLC's specialty?

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

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, 17 practice at this address and 79 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Novant Health Medical Group LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 1 other insurer 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 March 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.