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NOVANT HEALTH PEDIATRICS LAKE NORMAN
NPI 1578057394
Pediatrics in Mooresville, NC

Active since June 15, 2018CLIA 34D0677390 · Certificate of Compliance
656 CARPENTER AVE, MOORESVILLE, NC 28115(704) 664-5133(704) 660-0406 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 20, 2024, Jul 11, 2023, Aug 16, 2021 and 1 more (4 updates tracked since 2018).

About Novant Health Pediatrics Lake Norman NPPES

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

NOVANT HEALTH PEDIATRICS LAKE NORMAN (NPI 1578057394) is a healthcare organization registered as a pediatrics in Mooresville, North Carolina and active in the NPI registry since June 2018. The organization holds a CLIA Certificate of Compliance certificate valid through December 15, 2027 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1578057394
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address656 CARPENTER AVEMooresville, NC 28115-2538
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (844) 266-8268
Phone(704) 664-5133
Fax(704) 660-0406
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateJune 15, 2018
Last NPPES UpdateJune 20, 20244 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
✔ NPI 1578057394 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.
656 CARPENTER AVE, Mooresville, NC 28115
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Other Names 1

Doing Business AsNovant Health Pediatrics Lake Norman

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 ›

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 Compliance 34D0677390

Novant Health Pediatrics Lake Norman Mooresville · Mooresville, NC
Active · expires Dec 15, 2027
CLIA Number34D0677390
Laboratory TypePhysician Office
Certificate Effective DateDecember 16, 2025
Certificate Expiration DateDecember 15, 2027
Laboratory DirectorKevin Wellbaum
Laboratory Phone(704) 664-5133
Laboratory LocationNovant Health Pediatrics Lake Norman Mooresville656 Carpenter Avenue, Mooresville, NC 28115
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY POTEAT FERGUSON M.D.
Pediatrics
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133
LAURA O'DONNELL M.D.
Pediatrics
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133
JENNIFER GIBSON LEGGETT
Nurse Practitioner
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133
LAKE NORMAN PEDIATRICS, PA
Pediatrics
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-1297
COURTNEY RENEA HAYES FNP
Nurse Practitioner
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133
AVANI MAHENDRA DOSHI M.D.
Pediatrics (Adolescent Medicine)
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133
FRANCESCA MELOY DEVINE DO
Pediatrics
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133
AMY MOORE
Nurse Practitioner
656 CARPENTER AVE
MOORESVILLE, NC 28115
Iredell County (704) 664-5133

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 1578057394. It was assigned to this organization in the NPPES registry on June 15, 2018. The provider is doing business as Novant Health Pediatrics Lake Norman.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 656 Carpenter Ave, Mooresville, NC 28115. The listed phone number is (704) 664-5133.

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 Compliance (number 34D0677390) is associated with this NPI, valid through December 15, 2027. 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 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.