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NOVANT HEALTH MEDICAL GROUP LLC
NPI 1275480790
Surgery - Vascular Surgery in Charlotte, NC

Active since March 13, 2026
125 QUEENS RD STE 250, CHARLOTTE, NC 28204(704) 000-0000 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 6, 2026, Apr 1, 2026, Mar 13, 2026 (3 updates tracked since 2026).

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 1275480790), doing business as Novant Health Heart & Vascular - Elizabeth (vascular Surgery), is a healthcare organization registered as a vascular surgery in Charlotte, North Carolina and active in the NPI registry since March 2026. The organization lists Leea Jeanine Walton, Manager, as its authorized official.

NPPES Registry Identity

NPI1275480790
Entity TypeOrganization
Primary Taxonomy2086S0129X
Legal Business NameNOVANT HEALTH MEDICAL GROUP LLC
Location Address125 QUEENS RD STE 250Charlotte, NC 28204-3419
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(704) 000-0000
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonManager · (336) 515-7085
Enumeration DateMarch 13, 2026
Last NPPES UpdateMay 6, 20263 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1275480790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
125 QUEENS RD STE 250, Charlotte, NC 28204
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Other Names 1

Doing Business AsNovant Health Heart & Vascular - Elizabeth (vascular Surgery)

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

HANNAH RAE FLYNN ACNP
Nurse Practitioner (Acute Care)
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
NOVANT HEALTH MEDICAL GROUP LLC
Podiatrist
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-2340
ELIZABETH LEE BECK PA
Physician Assistant
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
DESIREA' LA SHAY THOMPSON NP
Nurse Practitioner
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
BENJAMIN JAMES MUCCI PA-C
Physician Assistant
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
JESSAMYN VANIA SNEED
Physician Assistant
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
SARAH ROSE MCGRADY
Physician Assistant
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100
DR. JEFFREY EARL EVERETT MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
125 QUEENS RD STE 250
CHARLOTTE, NC 28204
Mecklenburg County (704) 316-5100

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 1275480790. It was assigned to this organization in the NPPES registry on March 13, 2026. The provider is doing business as Novant Health Heart & Vascular - Elizabeth (Vascular Surgery).

Where is Novant Health Medical Group LLC located?

Novant Health Medical Group LLC is located at 125 Queens Rd Ste 250, Charlotte, NC 28204. The listed phone number is (704) 000-0000.

What is Novant Health Medical Group LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

When was this NPI record last updated?

The NPPES record for Novant Health Medical Group LLC was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.