NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
NPI 1386019891
Pediatrics - Adolescent Medicine in Waxhaw, NC
NPI Status: Active since December 09, 2015
Contact Information
3614 PROVIDENCE RD S
SUITE 101
WAXHAW, NC
ZIP 28173
Phone: (704) 384-8460
Fax: (704) 384-8465
- Organization
- Pediatrics
- Adolescent Medicine
- Accepts Insurance
- CLIA Number: 34D2194580
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-16-2026
About NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Novant Health Child And Adolescent Medical Group, a pediatrician established in Waxhaw, North Carolina operating as a Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1386019891 assigned on December 2015. The practitioner's primary taxonomy code is 2080A0000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Novant Health Child And Adolescent Medical Group 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 Child And Adolescent Medical Group. The authorized official of this NPI record is Leea Jeanine Walton (Rcs Manager)
- NPI
- 1386019891
- Provider Legal Name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Other Organization Name
- NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3614 PROVIDENCE RD S SUITE 101 WAXHAW, NC 28173
- Location Phone
- (704) 384-8460
- Location Fax
- (704) 384-8465
- Mailing Address
- PO BOX 60447 CHARLOTTE, NC 28260
- Mailing Phone
- (704) 384-7840
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-09-2015
- Last Update Date
- 06-20-2024
- Code Navigator
A pediatrician like Novant Health Child And Adolescent Medical Group 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 Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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:
- 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.
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
- 34D2194580
- Facility Type
- Physician Office
- Certificate Effective Date
- January 17, 2024
- Certificate Expiration Date
- January 16, 2026
- Laboratory Director
- LORI YANCHIK-CASTRO
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Novant Health Child And Adolescent Medical Group 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 1386019891, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
WAXHAW, NC 28173
WAXHAW, NC 28173
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386019891, enumerated as an "organization" on December 09, 2015.
The provider is located at 3614 PROVIDENCE RD S SUITE 101 WAXHAW, NC 28173 and the phone number is (704) 384-8460.
Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC. Please consult your insurance carrier or call the provider to verify.
