NOVANT HEALTH PEDIATRICS BRUNSWICK
NPI 1235798992
Pediatrics in Supply, NC

NPI Status: Active since June 06, 2019

Contact Information

20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC
ZIP 28462
Phone: (704) 384-0517

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  • Organization
  • Pediatrics
  • Accepts Insurance
  • CLIA Number: 34D2170564
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-15-2028

About NOVANT HEALTH PEDIATRICS BRUNSWICK

This page provides the complete NPI Profile along with additional information for Novant Health Pediatrics Brunswick, a pediatrician established in Supply, North Carolina operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1235798992 assigned on June 2019. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Novant Health Pediatrics Brunswick operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Novant Health Pediatrics Brunswick. The authorized official of this NPI record is Leea Jeanine Walton (Rcs Manager)

NPI
1235798992
Provider Legal Name
NOVANT HEALTH MEDICAL GROUP, LLC
Other Organization Name
NOVANT HEALTH PEDIATRICS BRUNSWICK
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
20 MEDICAL CAMPUS DR NW STE 205 SUPPLY, NC 28462
Location Phone
(704) 384-0517
Mailing Address
PO BOX 60447 CHARLOTTE, NC 28260
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-06-2019
Last Update Date
06-20-2024
Code Navigator

A pediatrician like Novant Health Pediatrics Brunswick is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
  • Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Gold Standard A | Nationwide Doctors - PPO
  • Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Silver Standard | Nationwide Doctors - PPO
  • Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
  • Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
  • Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
  • Blue Care Bronze Standard | Statewide Doctors - HMO
  • Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
  • Blue Care Gold Standard A | Statewide Doctors - HMO
  • Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
  • Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
  • Blue Care Silver Standard | Statewide Doctors - HMO
  • Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Novant Health - EPO
  • Blue Home Bronze Standard | with Novant Health - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LEEA JEANINE WALTON

Authorized Official Title
RCS MANAGER
Authorized Official Phone
(704) 316-6081

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D2170564
Facility Type
Physician Office
Certificate Effective Date
March 16, 2026
Certificate Expiration Date
March 15, 2028
Laboratory Director
LORI A. TACKMAN
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Novant Health Pediatrics Brunswick after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235798992, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 7 → 14 → 5 8 → 16 → 7 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 1 + 4 + 9 + 1 + 6 + 9 + 1 + 8 + 24 = 78

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 78 is 80. The difference is the calculated check digit.

80 - 78 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1235798992.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Pediatrics
20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC 28462
Nurse Practitioner
20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC 28462
Student in an Organized Health Care Education/Training Program
20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC 28462

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235798992, enumerated as an "organization" on June 06, 2019.

The provider is located at 20 MEDICAL CAMPUS DR NW STE 205 SUPPLY, NC 28462 and the phone number is (704) 384-0517.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.