NOVANT HEALTH PROVIDENCE OB/GYN - NPI 1679012660 - Obstetrics & Gynecology in Charlotte, NC

Q: What is Novant Health Medical Group, LLC's NPI number?

The NPI number for Novant Health Medical Group, LLC is 1679012660. It was assigned to this organization in the NPPES registry on February 23, 2017. The provider is doing business as Novant Health Providence Ob/Gyn.

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

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Obstetrics, with taxonomy code 207VX0000X.

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About Novant Health Providence Ob/gyn NPPES

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

NOVANT HEALTH PROVIDENCE OB/GYN (NPI 1679012660) is a healthcare organization registered as an obstetrics in Charlotte, North Carolina and active in the NPI registry since February 2017. The organization holds a CLIA Microscopy certificate valid through April 11, 2027 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1679012660

Entity TypeOrganization

Primary Taxonomy207VX0000X

Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC

Location Address6324 FAIRVIEW RD STE 430Charlotte, NC 28210-4278

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(704) 316-3148

Fax(704) 316-3149

Organization SubpartNo

Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081

Enumeration DateFebruary 23, 2017

Last NPPES UpdateJune 20, 20245 updates tracked since enumeration

NPPES CertifiedJune 20, 2024

✔ NPI 1679012660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · ObstetricsAllopathic & Osteopathic Physicians

Taxonomy Code207VX0000X

Definition

A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee

6324 FAIRVIEW RD STE 430, Charlotte, NC 28210

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Other Names 1

Doing Business AsNovant Health Providence Ob/gyn

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 for Provider-Performed Microscopy Procedures (PPMP) 34D2129103

Novant Health Providence Ob/Gyn - Southpark · Charlotte, NC

Active · expires Apr 11, 2027

CLIA Number34D2129103

Laboratory TypePhysician Office

Certificate Effective DateApril 12, 2025

Certificate Expiration DateApril 11, 2027

Laboratory DirectorEleanor Mccurdy

Laboratory Phone(704) 316-3148

Laboratory LocationNovant Health Providence Ob/Gyn - Southpark6324 Fairview Road, Suite 430, Charlotte, NC 28210

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 7

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

MELISSA YEUNG COGGIN FNP-C

Nurse Practitioner