NOVANT HEALTH NORTHLAKE DERMATOLOGY
NPI 1396751640
Dermatology - Dermatopathology in Huntersville, NC
NPI Status: Active since July 31, 2006
Contact Information
9604 HOLLY POINT DR
HUNTERSVILLE, NC
ZIP 28078
Phone: (704) 316-5070
Fax: (704) 316-5075
- Organization
- Dermatology
- Dermatopathology
- Accepts Insurance
- CLIA Number: 34D1058814
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-12-2026
About NOVANT HEALTH NORTHLAKE DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Novant Health Northlake Dermatology, a provider established in Huntersville, North Carolina operating as a Dermatology, focusing in dermatopathology . The healthcare provider is registered in the NPI registry with number 1396751640 assigned on July 2006. The practitioner's primary taxonomy code is 207ND0900X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Novant Health Northlake Dermatology 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 Northlake Dermatology. The authorized official of this NPI record is Leea Jeanine Walton (Rcs Manager)
- NPI
- 1396751640
- Provider Legal Name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Other Organization Name
- NOVANT HEALTH NORTHLAKE DERMATOLOGY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 9604 HOLLY POINT DR HUNTERSVILLE, NC 28078
- Location Phone
- (704) 316-5070
- Location Fax
- (704) 316-5075
- Mailing Address
- PO BOX 60447 CHARLOTTE, NC 28260
- Mailing Phone
- (704) 316-5070
- Mailing Fax
- (704) 316-5075
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-31-2006
- Last Update Date
- 06-19-2024
- Code Navigator
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
Dermatology Dermatopathology
- Taxonomy Code
- 207ND0900X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology |
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
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 018GV | OTHER (01) | NC | BCBS |
| NPB181 | MEDICAID (05) | SC | |
| 5904331 | MEDICAID (05) | NC |
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
- 34D1058814
- Facility Type
- Physician Office
- Certificate Effective Date
- February 13, 2024
- Certificate Expiration Date
- February 12, 2026
- Laboratory Director
- JOSE R. PENA
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Novant Health Northlake Dermatology 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 1396751640, we treat the final digit (0) 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 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).
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 70 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396751640, enumerated as an "organization" on July 31, 2006.
The provider is located at 9604 HOLLY POINT DR HUNTERSVILLE, NC 28078 and the phone number is (704) 316-5070.
Dermatology with taxonomy code 207ND0900X and a focus in Dermatopathology.
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
