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NOVANT HEALTH SOUTH PARK FAMILY PHYSICIANS
NPI 1770511313
Family Medicine in Charlotte, NC

Active since June 30, 2006
6324 FAIRVIEW ROAD, SUITE 201, CHARLOTTE, NC 28210(704) 384-0588(704) 384-0580 Get Directions Write a Review

NPPES record last updated: July 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2024, Jul 12, 2023, Aug 18, 2021 (3 updates tracked since 2021).

About Novant Health South Park Family Physicians NPPES

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

NOVANT HEALTH SOUTH PARK FAMILY PHYSICIANS (NPI 1770511313) is a healthcare organization registered as a family medicine in Charlotte, North Carolina and active in the NPI registry since June 2006. The organization lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1770511313
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address6324 FAIRVIEW ROAD, SUITE 201Charlotte, NC 28210-4278
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-0588 · Fax (704) 384-0580
Phone(704) 384-0588
Fax(704) 384-0580
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateJune 30, 2006
Last NPPES UpdateJuly 9, 20243 updates tracked since enumeration
NPPES CertifiedJuly 9, 2024
✔ NPI 1770511313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6324 FAIRVIEW ROAD, Charlotte, NC 28210
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Other Names 1

Doing Business AsNovant Health South Park Family Physicians

Other Identifiers 4

OtherCC5118NC · Railroad Medicare
Other017X3NC · Bcbs Nc
MedicaidNPB165SC
Medicaid5903451NC

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 34D1053256

Novant Health South Park Family Physicians · Charlotte, NC
Expired · Jul 31, 2026
CLIA Number34D1053256
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2022
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorPeter B. Mack
Laboratory Phone(704) 384-0588
Laboratory LocationNovant Health South Park Family Physicians6324 Fairview Road, Suite 201 Attn Christine Lee, Charlotte, NC 28210
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

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

JANET AIKEN MD
Internal Medicine
6324 FAIRVIEW ROAD, SUITE 310
CHARLOTTE, NC 28210
Mecklenburg County (704) 316-6565

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 1770511313. It was assigned to this organization in the NPPES registry on June 30, 2006. The provider is doing business as Novant Health South Park Family Physicians.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 6324 Fairview Road Suite 201, Charlotte, NC 28210. The listed phone number is (704) 384-0588.

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

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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 July 9, 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.