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NOVANT HEALTH WAVERLY PEDIATRICS AND PRIMARY CARE
NPI 1871527762
Family Medicine in Charlotte, NC

Active since July 10, 2006
11840 SOUTHMORE DR, SUITE 200, CHARLOTTE, NC 28277(704) 384-1166(704) 384-1181 Get Directions Write a Review

NPPES record last updated: June 21, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 21, 2024, Jul 12, 2023, Aug 16, 2021 and 1 more (4 updates tracked since 2015).

About Novant Health Waverly Pediatrics And Primary Care NPPES

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

NOVANT HEALTH WAVERLY PEDIATRICS AND PRIMARY CARE (NPI 1871527762) is a healthcare organization registered as a family medicine in Charlotte, North Carolina and active in the NPI registry since July 2006. The organization lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1871527762
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address11840 SOUTHMORE DR, SUITE 200Charlotte, NC 28277-4466
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-1166 · Fax (704) 384-1181
Phone(704) 384-1166
Fax(704) 384-1181
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateJuly 10, 2006
Last NPPES UpdateJune 21, 20244 updates tracked since enumeration
NPPES CertifiedJune 21, 2024
✔ NPI 1871527762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.

Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPediatricsTaxonomy 208000000X
11840 SOUTHMORE DR, Charlotte, NC 28277
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Other Names 1

Doing Business AsNovant Health Waverly Pediatrics And Primary Care

Other Identifiers 4

Medicaid5901214NC
OtherCC5118NC · Railroad Medicare
Other016XUNC · Bcbs-nc
MedicaidNPB256SC

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 34D0873395

Novant Health Waverly Pediatrics And Primary Care · Charlotte, NC
Expired · Jul 10, 2026
CLIA Number34D0873395
Laboratory TypeHealth Main. Organization
Certificate Effective DateJuly 11, 2024
Certificate Expiration DateJuly 10, 2026
Laboratory DirectorBrett Christoffersen
Laboratory Phone(704) 384-1166
Laboratory LocationNovant Health Waverly Pediatrics And Primary Care11840 Southmore Drive, Suite 200, Charlotte, NC 28277
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 20

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

CAROLINA MEDICORP ENTERPRISES, INC
Emergency Medicine
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4440
DR. JOHN KETRON M.D.
Pediatrics
11840 SOUTHMORE DR, SUITE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 384-1166
MR. MATTHEW WILLIAM GRIMM P.T.
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443
G ABRAMS & R COHEN XV PC
Dentist
11840 SOUTHMORE DR, SUITE 150
CHARLOTTE, NC 28277
Mecklenburg County (305) 297-1344
NOVANT MEDICAL GROUP, INC
Psychiatry & Neurology (Neurology)
11840 SOUTHMORE DR, SUITE 201
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-9001
MS. KRISTIN MICHELLE HIETBRINK PT
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443
DR. GREGORY BIELEC M.D.
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443
ERICA CHERIE EVANS MD
Family Medicine
11840 SOUTHMORE DR, SUITE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 384-1166

Frequently Asked Questions

What is NOVANT HEALTH MEDICAL GROUP, LLC's NPI number?

The NPI number assigned to this healthcare provider is 1871527762, enumerated as an "organization" on July 10, 2006.

Where is the provider located?

The provider is located at 11840 SOUTHMORE DR SUITE 200 CHARLOTTE, NC 28277 and the phone number is (704) 384-1166.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.

What insurance does NOVANT HEALTH MEDICAL GROUP, LLC accept?

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Medicare,. Please consult your insurance carrier or call the provider to verify.