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: October 18, 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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Novant Health Pediatrics Southpark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2,991

Medicare enrollment records show 2,991 clinicians reassign Medicare billing to Novant Health Pediatrics Southpark, which bills Medicare for the services they deliver. Of these, 46 practice at this address and 956 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 63

Nurse Practitioner759
Family Practice327
Hospitalist302
Pediatric Medicine233
Obstetrics/Gynecology187
Internal Medicine178
Neurology150
Cardiovascular Disease (Cardiology)94
55 other specialties761

Nearest to this location (20)

See all 2,991
Nurse Practitioner
NPI 1174412902
6324 FAIRVIEW RD STE 201
Charlotte, NC 28210
(704) 384-0588
✔ PECOS✔ Accepts MedicareSame address
Hospitalist
NPI 1063618312
6324 FAIRVIEW RD STE 310
Charlotte, NC 28210
(704) 316-6565
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1538131818
6324 FAIRVIEW RD STE 310
Charlotte, NC 28210
(980) 302-8680
✔ PECOS✔ Accepts MedicareSame address
Geriatric Medicine
NPI 1558922641
6324 FAIRVIEW RD STE 310
Charlotte, NC 28210
(704) 316-6565
✔ PECOS✔ Accepts MedicareSame address
Obstetrics/Gynecology
NPI 1104320563
6324 FAIRVIEW RD STE 430
Charlotte, NC 28210
(704) 316-3148
✔ PECOS✔ Accepts MedicareSame address
Neurology
NPI 1477136711
6324 FAIRVIEW RD STE 400
Charlotte, NC 28210
(406) 281-1173
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1205898764
6324 FAIRVIEW RD SUITE 350
Charlotte, NC 28210
(704) 384-8600
✔ PECOSSame address
Certified Nurse Midwife (CNM)
NPI 1588044911
6324 FAIRVIEW RD STE 430
Charlotte, NC 28210
(704) 316-3148
✔ PECOSSame address
Pediatric Medicine
NPI 1881689651
6324 FAIRVIEW RD SUITE 350
Charlotte, NC 28210
(704) 384-8600
✔ PECOSSame address
Family Practice
NPI 1245735315
6324 FAIRVIEW RD STE 201
Charlotte, NC 28210
(704) 384-0588
✔ PECOS✔ Accepts MedicareSame address
Pediatric Medicine
NPI 1710322367
6324 FAIRVIEW RD SUITE 350
Charlotte, NC 28210
(704) 384-8600
✔ PECOSSame address
Neurology
NPI 1831732809
6324 FAIRVIEW RD STE 400
Charlotte, NC 28210
(980) 302-6400
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1376676601
6324 FAIRVIEW RD STE 460
Charlotte, NC 28210
(980) 302-8611
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1255945085
6324 FAIRVIEW RD STE 460
Charlotte, NC 28210
(980) 302-8611
✔ PECOS✔ Accepts MedicareSame address
Rheumatology
NPI 1215228655
6324 FAIRVIEW RD STE 330
Charlotte, NC 28210
(704) 316-1950
✔ PECOS✔ Accepts MedicareSame address
Marriage and Family Therapist
NPI 1083237598
6324 FAIRVIEW RD STE 460
Charlotte, NC 28210
(980) 302-8611
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1922202225
6324 FAIRVIEW RD SUITE 201
Charlotte, NC 28210
(704) 384-0588
✔ PECOSSame address
Obstetrics/Gynecology
NPI 1467471771
6324 FAIRVIEW RD STE 430
Charlotte, NC 28210
(704) 316-3148
✔ PECOS✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1245548999
6324 FAIRVIEW RD STE 202
Charlotte, NC 28210
(980) 302-9740
✔ Accepts MedicareSame address
Urology
NPI 1750380549
6324 FAIRVIEW RD STE 420
Charlotte, NC 28210
(704) 316-1120
✔ PECOS✔ Accepts MedicareSame address
See all 2,991 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Rd, 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.

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.

Is Novant Health Medical Group, LLC enrolled in Medicare?

Yes. Novant Health Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Novant Health Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2,991 clinicians in 63 Medicare specialties reassign their Medicare billing to Novant Health Medical Group, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (759), Family Practice (327) and Hospitalist (302). Of these, 46 practice at this address and 956 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 and Cigna Healthcare 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.