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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: October 18, 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, Cigna Healthcare.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 Lake Norman 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 Lake Norman, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 79 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
Francesca Devine, DO
Pediatric Medicine
NPI 1972131993
656 CARPENTER AVE
Mooresville, NC 28115
(704) 664-5133
✔ PECOSSame address
Courtney Hayes, FNP
Nurse Practitioner
NPI 1659906006
656 CARPENTER AVE
Mooresville, NC 28115
(704) 664-5133
✔ PECOSSame address
Jennifer Leggett
Nurse Practitioner
NPI 1225761208
656 CARPENTER AVE
Mooresville, NC 28115
(704) 664-5133
✔ PECOSSame address
Amy Moore
Nurse Practitioner
NPI 1972204360
656 CARPENTER AVE
Mooresville, NC 28115
(704) 664-5133
✔ PECOSSame address
Laura O Donnell, M.D.
Pediatric Medicine
NPI 1215912803
656 CARPENTER AVE
Mooresville, NC 28115
(704) 664-5133
✔ PECOSSame address
Madan Aryal, MD
Hematology/Oncology
NPI 1982983391
170 MEDICAL PARK RD STE 101
Mooresville, NC 28117
(980) 302-7070
✔ PECOS✔ Accepts Medicare3.5 mi
Lauri Best, MD
Obstetrics/Gynecology
NPI 1841253135
235 MEDICAL PARK RD STE 201
Mooresville, NC 28117
(704) 658-9211
✔ PECOS✔ Accepts Medicare3.5 mi
Michael Madigan, MD
Cardiovascular Disease (Cardiology)
NPI 1194245167
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(980) 302-7800
✔ PECOS✔ Accepts Medicare3.5 mi
Kobina Wilmot, M.D.
Cardiovascular Disease (Cardiology)
NPI 1356667505
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(980) 302-7800
✔ PECOS✔ Accepts Medicare3.5 mi
Kathleen Lagesse, AGNP-C
Nurse Practitioner
NPI 1316496862
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(980) 302-7800
✔ PECOS✔ Accepts Medicare3.6 mi
Suraj Arora, M.D.
Pulmonary Disease
NPI 1033420922
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(704) 384-7972
✔ PECOS✔ Accepts Medicare3.6 mi
Michael Cantor, DO
Cardiovascular Disease (Cardiology)
NPI 1760635486
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(980) 302-7800
✔ PECOS✔ Accepts Medicare3.6 mi
Arabindra Katwal, M.D.
Interventional Cardiology
NPI 1710010343
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(980) 302-7800
✔ PECOS✔ Accepts Medicare3.6 mi
Yashoda Bhandari, DNP
Nurse Practitioner
NPI 1275127664
134 MEDICAL PARK RD STE 200
Mooresville, NC 28117
(980) 302-7800
✔ PECOS✔ Accepts Medicare3.6 mi
Alexis Gibson
Clinical Social Worker
NPI 1720802457
171 FAIRVIEW RD
Mooresville, NC 28117
(704) 660-4000
✔ PECOS✔ Accepts Medicare3.7 mi
Jason Barnett, LCSWA
Clinical Social Worker
NPI 1972917144
542 WILLIAMSON RD SUITE 6
Mooresville, NC 28117
(704) 660-6854
✔ PECOS3.8 mi
Gianna Madrid, M.D.
Pediatric Medicine
NPI 1083698005
133 WELTON WAY STE C
Mooresville, NC 28117
(704) 664-2552
✔ PECOS4.2 mi
Kevin Wellbaum, M.D.
Pediatric Medicine
NPI 1790049641
133 WELTON WAY STE C
Mooresville, NC 28117
(704) 664-2552
✔ PECOS4.2 mi
Clint Beaver, MD
Family Practice
NPI 1558565838
106 CORPORATE PARK DR SUITE 200 & 300
Mooresville, NC 28117
(704) 235-9090
✔ PECOS✔ Accepts Medicare4.2 mi
Cody Homistek, D.O.
Family Practice
NPI 1306292669
106 CORPORATE PARK DR SUITE 200 & 300
Mooresville, NC 28117
(704) 235-9090
✔ PECOS✔ Accepts Medicare4.2 mi
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 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.

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.

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, 5 practice at this address and 79 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 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 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.