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: October 25, 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
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

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Novant Health Primary Care South End is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2,991

Medicare enrollment records show 2,991 clinicians reassign Medicare billing to Novant Health Primary Care South End, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 730 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 63

Nurse Practitioner759
Family Practice327
Hospitalist302
Pediatric Medicine233
Obstetrics/Gynecology187
Internal Medicine178
Neurology150
Cardiovascular Disease (Cardiology)94
55 other specialties761

Nearest to this location (20)

See all 2,991
Nurse Practitioner
NPI 1538822911
2400 SOUTH BLVD STE 200
Charlotte, NC 28203
(704) 774-3024
✔ PECOSSame address
Pediatric Medicine
NPI 1851319420
2400 SOUTH BLVD STE 200
Charlotte, NC 28203
(704) 774-3024
✔ PECOSSame address
Nurse Practitioner
NPI 1760844096
2400 SOUTH BLVD STE 200
Charlotte, NC 28203
(704) 774-3024
✔ PECOSSame address
Nurse Practitioner
NPI 1437411436
2400 SOUTH BLVD STE 103
Charlotte, NC 28203
(704) 316-3017
✔ PECOS✔ Accepts MedicareSame address
Obstetrics/Gynecology
NPI 1689808123
2400 SOUTH BLVD STE 103
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1467089185
2400 SOUTH BLVD STE 103
Charlotte, NC 28203
(704) 316-3017
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1821823261
2400 SOUTH BLVD STE 200
Charlotte, NC 28203
(704) 774-3024
✔ PECOS✔ Accepts MedicareSame address
Pediatric Medicine
NPI 1649667585
2400 SOUTH BLVD STE 200
Charlotte, NC 28203
(704) 774-3024
✔ PECOSSame address
Obstetrics/Gynecology
NPI 1679707111
2100 S. TRYON ST. STE 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1750557021
2100 S TRYON ST
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1790077311
2100 S TRYON ST STE 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1609070093
2100 S TRYON ST UNIT 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1467899948
2100 S TRYON ST UNIT 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1952861098
2100 S TRYON ST STE 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1497072177
2100 S TRYON ST STE 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1366769044
2100 S TRYON ST STE 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Obstetrics/Gynecology
NPI 1427685668
2100 S TRYON ST UNIT 201
Charlotte, NC 28203
(704) 316-3000
✔ PECOS✔ Accepts Medicare0.5 mi
Nurse Practitioner
NPI 1912464801
901 EAST BLVD
Charlotte, NC 28203
(704) 355-6560
✔ PECOS0.8 mi
Nurse Practitioner
NPI 1699248336
1900 SCOTT AVE STE 201A
Charlotte, NC 28203
(703) 381-0280
✔ PECOS1.1 mi
Pediatric Medicine
NPI 1750842910
1315 EAST BLVD STE 280
Charlotte, NC 28203
(910) 754-8808
✔ PECOS1.2 mi
See all 2,991 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Blvd, Ste 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.

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.

Is Novant Health Medical Group, LLC enrolled in Medicare?

Yes. Novant Health Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Novant Health Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2,991 clinicians in 63 Medicare specialties reassign their Medicare billing to Novant Health Medical Group, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (759), Family Practice (327) and Hospitalist (302). Of these, 8 practice at this address and 730 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 and Cigna Healthcare 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.