NOVANT HEALTH MEDICAL GROUP, LLC
NPI 1336978063
Orthopaedic Surgery in Supply, NC

NPI Status: Active since July 31, 2024

Contact Information

20 MEDICAL CAMPUS DR NW STE 104
SUPPLY, NC
ZIP 28462
Phone: (910) 575-5800
Fax: (910) 579-1174

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  • Organization
  • Orthopaedic Surgery
  • CLIA Number: 34D2313756
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-05-2026

About NOVANT HEALTH MEDICAL GROUP, LLC

This page provides the complete NPI Profile along with additional information for Novant Health Medical Group, Llc, a provider established in Supply, North Carolina operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1336978063 assigned on July 2024. The practitioner's primary taxonomy code is 207X00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Novant Health Medical Group, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Leea Jeanine Walton (Managed Care Manager)

NPI
1336978063
Provider Name
NOVANT HEALTH MEDICAL GROUP, LLC
Entity Type
Organization
Location Address
20 MEDICAL CAMPUS DR NW STE 104 SUPPLY, NC 28462
Location Phone
(910) 575-5800
Location Fax
(910) 579-1174
Mailing Address
PO BOX 60447 CHARLOTTE, NC 28260
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-31-2024
Last Update Date
07-31-2024
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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

Orthopaedic Surgery

Taxonomy Code
207X00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

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.

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
MANAGED CARE MANAGER
Authorized Official Phone
(047) 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
34D2313756
Facility Type
Physician Office
Certificate Effective Date
November 06, 2024
Certificate Expiration Date
November 05, 2026
Laboratory Director
RICHARD LEIGHTON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Novant Health Medical Group, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1336978063
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
236618716012
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 1 + 8 + 7 + 1 + 6 + 0 + 1 + 2 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1336978063 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

BRENDA KAY DUSHEK OPA-C

Physician Assistant

(Surgical)

20 MEDICAL CAMPUS DR NW STE 104
SUPPLY, NC
ZIP 28462

(910) 575-5800

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336978063, enumerated as an "organization" on July 31, 2024.

The provider is located at 20 MEDICAL CAMPUS DR NW STE 104 SUPPLY, NC 28462 and the phone number is (910) 575-5800.

Orthopaedic Surgery with taxonomy code 207X00000X.