NOVANT HEALTH PEDIATRICS SOUTHPARK
NPI 1467490102
Pediatrics in Charlotte, NC

Active since June 03, 2006CLIA 34D0244004 · Waiver
6324 FAIRVIEW RD, SUITE 350, CHARLOTTE, NC 28210(704) 384-8600(704) 384-8610 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 20, 2024, Jul 11, 2023, Aug 16, 2021 and 1 more (4 updates tracked since 2017).

About Novant Health Pediatrics Southpark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVANT HEALTH PEDIATRICS SOUTHPARK (NPI 1467490102) is a healthcare organization registered as a pediatrics in Charlotte, North Carolina and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through February 11, 2028 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1467490102
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address6324 FAIRVIEW RD, SUITE 350Charlotte, NC 28210-4171
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-8600 · Fax (704) 384-8610
Fax(704) 384-8610
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateJune 3, 2006
Last NPPES UpdateJune 20, 20244 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
NPI 1467490102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

6324 FAIRVIEW RD, Charlotte, NC 28210

Other Names 1

Doing Business AsNovant Health Pediatrics Southpark

Other Identifiers 3

MedicaidNPA712SC
Other0273WNC · Bcbs Nc
Medicaid890273WNC

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0244004

Novant Health Pediatrics - Southpark · Charlotte, NC
Active · expires Feb 11, 2028
CLIA Number34D0244004
Laboratory TypePhysician Office
Certificate Effective DateFebruary 12, 2026
Certificate Expiration DateFebruary 11, 2028
Laboratory DirectorJanie Chai
Laboratory Phone(704) 384-8600
Laboratory LocationNovant Health Pediatrics - Southpark6324 Fairview Road, Suite 350, Charlotte, NC 28210
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

Family Medicine
6324 FAIRVIEW RD, SUITE 201
CHARLOTTE, NC 28210
Internal Medicine
6324 FAIRVIEW RD, SUITE 310
CHARLOTTE, NC 28210
Radiology (Diagnostic Radiology)
6324 FAIRVIEW RD, SUITE 120 A
CHARLOTTE, NC 28210
Internal Medicine (Geriatric Medicine)
6324 FAIRVIEW RD, SUITE 310
CHARLOTTE, NC 28210
Radiology (Diagnostic Radiology)
6324 FAIRVIEW RD, SUITE 120 A
CHARLOTTE, NC 28210
Obstetrics & Gynecology
6324 FAIRVIEW RD, SUITE 390
CHARLOTTE, NC 28210
Nurse Practitioner
6324 FAIRVIEW RD, SUITE 350
CHARLOTTE, NC 28210
Physician Assistant
6324 FAIRVIEW RD
CHARLOTTE, NC 28210

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 1467490102. It was assigned to this organization in the NPPES registry on June 3, 2006. The provider is doing business as Novant Health Pediatrics Southpark.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 6324 Fairview Rd Suite 350, Charlotte, NC 28210. The listed phone number is (704) 384-8600.

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

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Novant Health Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0244004) is associated with this NPI, valid through February 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 June 20, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.