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NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS
NPI 1730439944
Emergency Medicine in Cornelius, NC

Active since September 14, 2012CLIA Certified · 2 labs
19485 OLD JETTON RD, SUITE 100, CORNELIUS, NC 28031(704) 384-1775(704) 384-1776 Get Directions Write a Review

NPPES record last updated: February 27, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Novant Health Lakeside Family Physicians NPPES

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

NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS (NPI 1730439944) is a healthcare organization registered as an emergency medicine in Cornelius, North Carolina and active in the NPI registry since September 2012. The organization holds 2 active CLIA laboratory certificates and lists Geoffrey K Gardner, Vp Finance, as its authorized official.

NPPES Registry Identity

NPI1730439944
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NameNOVANT MEDICAL GROUP INC
Location Address19485 OLD JETTON RD, SUITE 100Cornelius, NC 28031-6582
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(704) 384-1775
Fax(704) 384-1776
Organization SubpartNo
Authorized OfficialGeoffrey K GardnerVp Finance · (704) 384-9094
Enumeration DateSeptember 14, 2012
Last NPPES UpdateFebruary 27, 2017
✔ NPI 1730439944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedFamily MedicineTaxonomy 207Q00000X
19485 OLD JETTON RD, Cornelius, NC 28031
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Other Names 1

Doing Business AsNovant Health Lakeside Family Physicians

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 2

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) 34D0690352

Novant Health Lakeside Family Physicians · Cornelius, NC
Active · expires Aug 23, 2027
CLIA Number34D0690352
Laboratory TypePhysician Office
Certificate Effective DateAugust 24, 2025
Certificate Expiration DateAugust 23, 2027
Laboratory DirectorCorey Mottesheard
Laboratory Phone(704) 384-1775
Laboratory LocationNovant Health Lakeside Family Physicians19485 Old Jetton Road, Suite 100 Attention Richard Taylor, Cornelius, NC 28031
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.

Certificate of Waiver 34D2130510

Novant Health Lakeside Family Physicians Antiquity · Cornelius, NC
Active · expires Sep 30, 2027
CLIA Number34D2130510
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorAndrew D. Blodgett
Laboratory Phone(704) 384-1782
Laboratory LocationNovant Health Lakeside Family Physicians Antiquity19830 Zion Avenue, Cornelius, NC 28031
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

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

DR. BRYAN TODD EDWARDS M.D.
Orthopaedic Surgery
19485 OLD JETTON RD, SUITE 210
CORNELIUS, NC 28031
Mecklenburg County (704) 316-1830
DR. AMY LOWERY ALEXANIAN M.D.
Family Medicine
19485 OLD JETTON RD, SUITE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
NOVANT HEALTH MEDICAL GROUP, LLC
Orthopaedic Surgery
19485 OLD JETTON RD, SUITE 210
CORNELIUS, NC 28031
Mecklenburg County (704) 316-1830
DR. CHRISTOPHER A ZAGAR M.D.
Family Medicine
19485 OLD JETTON RD, SUITE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
DR. MARK VINCENT M.D.
Family Medicine
19485 OLD JETTON RD, SUITE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
MICHAEL G RYAN M.D.
Family Medicine
19485 OLD JETTON RD, SUITE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
HEATHER CHRISTINE DOTY DO
Family Medicine
19485 OLD JETTON RD, SUITE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
DR. DAVID M COOK M.D.
Family Medicine
19485 OLD JETTON RD, SUITE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 834-1775

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 Medical Group Inc's NPI number?

The NPI number for Novant Medical Group Inc is 1730439944. It was assigned to this organization in the NPPES registry on September 14, 2012. The provider is doing business as Novant Health Lakeside Family Physicians.

Where is Novant Medical Group Inc located?

Novant Medical Group Inc is located at 19485 Old Jetton Rd Suite 100, Cornelius, NC 28031. The listed phone number is (704) 384-1775.

What is Novant Medical Group Inc's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Does Novant Medical Group Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Novant Medical Group Inc accept?

Health plans from Blue Cross and Blue Shield of NC list Novant Medical Group Inc 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 Medical Group Inc was last updated on February 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.