NOVANT HEALTH PEDIATRICS BRUNSWICK
NPI 1235798992
Pediatrics in Supply, NC

Active since June 06, 2019CLIA 34D2170564 · Waiver
20 MEDICAL CAMPUS DR NW STE 205, SUPPLY, NC 28462(704) 384-0517 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 20, 2024, Jul 11, 2023, Aug 16, 2021 and 1 more (4 updates tracked since 2019).

About Novant Health Pediatrics Brunswick NPPES

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

NOVANT HEALTH PEDIATRICS BRUNSWICK (NPI 1235798992) is a healthcare organization registered as a pediatrics in Supply, North Carolina and active in the NPI registry since June 2019. The organization holds a CLIA Waiver certificate valid through September 16, 2028 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1235798992
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address20 MEDICAL CAMPUS DR NW STE 205Supply, NC 28462-4094
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateJune 6, 2019
Last NPPES UpdateJune 20, 20244 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
✔ NPI 1235798992 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.
20 MEDICAL CAMPUS DR NW STE 205, Supply, NC 28462

Other Names 1

Doing Business AsNovant Health Pediatrics Brunswick

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

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 Pediatrics Brunswick 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 Pediatrics Brunswick, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 80 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
Orthopedic Surgery
NPI 1861489734
20 MEDICAL CAMPUS DR SUITE 104
Supply, NC 28462
(910) 575-5800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1922994151
20 MEDICAL CAMPUS DR NW STE 205
Supply, NC 28462
(910) 721-4400
✔ PECOSSame address
Nurse Practitioner
NPI 1841615770
20 MEDICAL CAMPUS DR NW STE 205
Supply, NC 28462
(910) 721-4400
✔ PECOSSame address
Pediatric Medicine
NPI 1497752968
20 MEDICAL CAMPUS DR NW STE 205
Supply, NC 28462
(910) 721-4400
✔ PECOSSame address
Internal Medicine
NPI 1124028014
13 MEDICAL CAMPUS DR NW SUITE 102
Supply, NC 28462
(910) 754-5988
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1720545130
13 MEDICAL CAMPUS DR NW STE 102
Supply, NC 28462
(910) 754-5988
✔ PECOS✔ Accepts Medicare0.1 mi
Orthopedic Surgery
NPI 1528419579
6 DOCTORS CIR STE 5
Supply, NC 28462
(910) 721-4370
✔ PECOS✔ Accepts Medicare0.7 mi
Orthopedic Surgery
NPI 1790075844
6 DOCTORS CIR STE 5
Supply, NC 28462
(910) 721-4370
✔ PECOS✔ Accepts Medicare0.7 mi
General Surgery
NPI 1710963475
257 HOSPITAL DRIVE SUITE 200
Bolivia, NC 28422
(910) 721-4000
✔ PECOS✔ Accepts Medicare1.5 mi
General Surgery
NPI 1215047543
257 HOSPITAL DRIVE SUITE 200
Bolivia, NC 28422
(910) 721-4000
✔ PECOS✔ Accepts Medicare1.5 mi
Family Practice
NPI 1306264122
257 HOSPITAL DR. SUITE 101
Bolivia, NC 28422
(910) 721-4100
✔ PECOS✔ Accepts Medicare1.5 mi
Hospitalist
NPI 1487148367
240 HOSPITAL DR NE
Bolivia, NC 28422
(910) 721-2070
✔ PECOS✔ Accepts Medicare1.7 mi
Internal Medicine
NPI 1205414398
240 HOSPITAL DR NE
Bolivia, NC 28422
(910) 721-2070
✔ PECOS✔ Accepts Medicare1.7 mi
Hospitalist
NPI 1669905972
240 HOSPITAL DR NE
Bolivia, NC 28422
(910) 721-2070
✔ PECOS✔ Accepts Medicare1.7 mi
Nurse Practitioner
NPI 1528715281
240 HOSPITAL DR NE
Bolivia, NC 28422
(910) 721-1000
✔ PECOS✔ Accepts Medicare1.7 mi
Gastroenterology
NPI 1285637108
240 HOSPITAL DR NE
Bolivia, NC 28422
(252) 527-6565
✔ PECOS✔ Accepts Medicare1.7 mi
Certified Nurse Midwife (CNM)
NPI 1205692365
584 HOSPITAL DR SUITE B
Bolivia, NC 28422
(630) 740-6161
✔ PECOS1.8 mi
Obstetrics/Gynecology
NPI 1457642134
584 HOSPITAL DRIVE SUITE B
Bolivia, NC 28422
(910) 721-4050
✔ PECOS✔ Accepts Medicare1.8 mi
Urology
NPI 1477716280
584 HOSPITAL DR NE UNIT D
Bolivia, NC 28422
(910) 721-4150
✔ PECOS✔ Accepts Medicare1.8 mi
General Practice
NPI 1134583768
584 HOSPITAL DR NE UNIT B
Bolivia, NC 28422
(910) 721-4050
✔ PECOS✔ Accepts Medicare1.8 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.

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 34D2170564

Novant Health Pediatrics - Brunswick · Supply, NC
Active · expires Sep 16, 2028
CLIA Number34D2170564
Laboratory TypePhysician Office
Certificate Effective DateSeptember 17, 2026
Certificate Expiration DateSeptember 16, 2028
Laboratory DirectorLori A. Tackman
Laboratory Phone(910) 721-4400
Laboratory LocationNovant Health Pediatrics - Brunswick20 Medical Campus Dr NW Ste 205, Supply, NC 28462
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 1235798992. It was assigned to this organization in the NPPES registry on June 6, 2019. The provider is doing business as Novant Health Pediatrics Brunswick.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 20 Medical Campus Dr NW Ste 205, Supply, NC 28462. The listed phone number is (704) 384-0517.

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

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

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, 4 practice at this address and 80 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 34D2170564) is associated with this NPI, valid through September 16, 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 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 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.