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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: August 16, 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
NOVANT MEDICAL GROUP, INC.
Pediatrics (Pediatric Gastroenterology)
11840 SOUTHMORE DR, SUITE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-5060
DR. MOLLY ELIZABETH GRIMM DPT
Physical Therapist (Orthopedic)
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
DR. ERIN ELIZABETH BALL PT, DPT
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443
MR. ERIC R FORD PT
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443
MS. KRISTIN MICHELLE HIETBRINK PT
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443
MR. MATTHEW WILLIAM GRIMM P.T.
Physical Therapist
11840 SOUTHMORE DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-4443

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 1871527762. It was assigned to this organization in the NPPES registry on July 10, 2006. The provider is doing business as Novant Health Waverly Pediatrics And Primary Care.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 11840 Southmore Dr Suite 200, Charlotte, NC 28277. The listed phone number is (704) 384-1166.

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 June 21, 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.