NOVANT HEALTH SOUTH LAKE OB/GYN
NPI 1962969774
Obstetrics & Gynecology in Concord, NC
About Novant Health South Lake Ob/gyn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NOVANT HEALTH SOUTH LAKE OB/GYN (NPI 1962969774) is a healthcare organization registered as an obstetrics & gynecology in Concord, North Carolina and active in the NPI registry since February 2019. The organization maintains a secondary practice location in Huntersville and lists Leea Jeanine Walton, Rcs Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Novant Health South Lake Ob/gyn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
561Medicare enrollment records show 561 clinicians reassign Medicare billing to Novant Health South Lake Ob/Gyn, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 85 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 23
Nearest to this location (20)
See all 561Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1962969774. It was assigned to this organization in the NPPES registry on February 28, 2019. The provider is doing business as Novant Health South Lake Ob/Gyn.
Where is Novant Health Medical Group, LLC located?
Novant Health Medical Group, LLC is located at 9955 Poplar Tent Rd, Concord, NC 28027. The listed phone number is (704) 316-4828.
What is Novant Health Medical Group, LLC's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Novant Health Medical Group, LLC enrolled in Medicare?
Yes. Novant Health Medical Group, LLC is registered in the Medicare PECOS enrollment system.
When is Novant Health Medical Group, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Novant Health Medical Group, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 561 clinicians in 23 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 Obstetrics/Gynecology (131), Nurse Practitioner (106) and Family Practice (87). Of these, 2 practice at this address and 85 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 June 20, 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.
# Novant Health South Lake Ob/gyn · NPI 1962969774
Obstetrics & Gynecology organization in Concord, North Carolina. Organization record, active in the CMS NPPES registry since February 28, 2019.
## Identity
- **NPI:** 1962969774 (Entity type: Organization)
- **Enumerated:** February 28, 2019
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **Legal business name:** Novant Health Medical Group, Llc
- **Organization subpart:** No
- **Authorized official:** Leea Walton, RCS MANAGER
## Practice location
- **Address:** 9955 POPLAR TENT RD, Concord, NC 28027-9304
- **Phone:** (704) 316-4828 · **Fax:** (704) 316-4829
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, North Carolina, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 561 clinicians in 23 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Obstetrics/Gynecology (131), Nurse Practitioner (106), Family Practice (87); 2 practice at this address and 85 within 10 miles; [full list](https://npiprofile.com/npi/1962969774/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1962969774) · Data from the CMS NPPES public registry.