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NOVANT HEALTH MEDICAL GROUP, LLC
NPI 1356394308
Family Medicine in Cornelius, NC

Active since May 19, 2006
19485 OLD JETTON RD STE 100, CORNELIUS, NC 28031(704) 384-1775(704) 384-1776 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 30, 2026, Jul 9, 2024, Jul 11, 2023 and 2 more (5 updates tracked since 2018).

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 1356394308), doing business as Novant Health Lakeside Family Physicians, is a healthcare organization registered as a family medicine in Cornelius, North Carolina and active in the NPI registry since May 2006. The organization maintains 6 additional practice locations and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1356394308
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address19485 OLD JETTON RD STE 100Cornelius, NC 28031-6583
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-1775 · Fax (704) 384-1776
Phone(704) 384-1775
Fax(704) 384-1776
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateMay 19, 2006
Last NPPES UpdateMarch 30, 20265 updates tracked since enumeration
NPPES CertifiedMarch 30, 2026
✔ NPI 1356394308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
Also ListedPhysical TherapistTaxonomy 225100000X
19485 OLD JETTON RD STE 100, Cornelius, NC 28031
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Other Names 1

Doing Business AsNovant Health Lakeside Family Physicians

Secondary Practice Locations 6

Location 110816 Black Dog Ln Ste 160Charlotte, NC 28214-1479 · Phone (704) 316-3970 · Fax (704) 316-3971
Location 26909 Prosperity Church RdHuntersville, NC 28078-6698 · Phone (704) 384-1425 · Fax (704) 384-1426
Location 314330 Oakhill Park Ln Ste 200BHuntersville, NC 28078-3407 · Phone (704) 316-1265 · Fax (704) 316-1266
Location 4269 Gillman Rd Ste 100Denver, NC 28037-7923 · Phone (704) 316-4930 · Fax (704) 316-4931
Location 519830 Zion AveCornelius, NC 28031-8495 · Phone (704) 384-1782 · Fax (704) 384-1783
Location 6106 Langtree Village Dr Ste 200Mooresville, NC 28117-7594 · Phone (704) 384-7101 · Fax (704) 384-7102

Other Identifiers 2

Other0215VNC · Bcbs-nc
Medicaid5903870NC

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 Blue Cross and Blue Shield of NC.Insurance ›

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.

DR. GERARDO PEREZ DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
DR. RACHEL ANNE LATTERICH DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
MICHAELA LYNNE ROBERTS MD
Family Medicine
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
DEVON VARNEY DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
JYOTHI PRAVALLIKA EDUPUGANTI DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
JAMIE DYVIG CREWS
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
DR. PUJA DALAL
Family Medicine
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
MRS. RACHEL LYNN PRITCHARD FNP-BC
Nurse Practitioner (Family)
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775

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 1356394308. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Novant Health Lakeside Family Physicians.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 19485 Old Jetton Rd Ste 100, Cornelius, NC 28031. The listed phone number is (704) 384-1775.

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

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Novant Health Medical Group, LLC accept?

Health plans from Blue Cross and Blue Shield of NC 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 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.