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NOVANT HEALTH PRIMARY CARE SOUTH END
NPI 1912447079
Family Medicine in Charlotte, NC

Active since March 08, 2017CLIA 34D2129916 · Waiver
2400 SOUTH BLVD STE 103, CHARLOTTE, NC 28203(704) 316-3017(704) 316-3018 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 11, 2023, Aug 16, 2021 and 1 more (4 updates tracked since 2021).

About Novant Health Primary Care South End NPPES

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

NOVANT HEALTH PRIMARY CARE SOUTH END (NPI 1912447079) is a healthcare organization registered as a family medicine in Charlotte, North Carolina and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through April 26, 2027 and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.

NPPES Registry Identity

NPI1912447079
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNOVANT HEALTH MEDICAL GROUP, LLC
Location Address2400 SOUTH BLVD STE 103Charlotte, NC 28203-5773
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 316-3017
Phone(704) 316-3017
Fax(704) 316-3018
Organization SubpartNo
Authorized OfficialLeea Jeanine WaltonRcs Manager · (704) 316-6081
Enumeration DateMarch 8, 2017
Last NPPES UpdateJuly 9, 20244 updates tracked since enumeration
NPPES CertifiedJuly 9, 2024
✔ NPI 1912447079 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.
2400 SOUTH BLVD STE 103, Charlotte, NC 28203
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Other Names 1

Doing Business AsNovant Health Primary Care South End

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 Waiver 34D2129916

Novant Health Primary Care South End · Charlotte, NC
Active · expires Apr 26, 2027
CLIA Number34D2129916
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorPulak S. Patel
Laboratory Phone(704) 316-3017
Laboratory LocationNovant Health Primary Care South End2400 South Boulevard, Suite 103, Charlotte, NC 28203
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MERCEDES LAUREL STANLEY DNP, CPNP
Nurse Practitioner
2400 SOUTH BLVD STE 103
CHARLOTTE, NC 28203
Mecklenburg County (704) 774-3024
MRS. NADIRAH NAFEESAH KEITH DNP, FNP-C, PMHNP-BC
Nurse Practitioner
2400 SOUTH BLVD STE 103
CHARLOTTE, NC 28203
Mecklenburg County (704) 316-3017
JEREMY ALLAN CARTER
Family Medicine
2400 SOUTH BLVD STE 103
CHARLOTTE, NC 28203
Mecklenburg County (704) 316-3017
LAURA LAURA AREHEART PA
Physician Assistant
2400 SOUTH BLVD STE 103
CHARLOTTE, NC 28203
Mecklenburg County (704) 316-3017
KATHLEEN WUNDER PERSAVICH MD
Obstetrics & Gynecology
2400 SOUTH BLVD STE 103
CHARLOTTE, NC 28203
Mecklenburg County (704) 316-3000

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 1912447079. It was assigned to this organization in the NPPES registry on March 8, 2017. The provider is doing business as Novant Health Primary Care South End.

Where is Novant Health Medical Group, LLC located?

Novant Health Medical Group, LLC is located at 2400 South Blvd Ste 103, Charlotte, NC 28203. The listed phone number is (704) 316-3017.

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

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

Does Novant Health Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2129916) is associated with this NPI, valid through April 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.