Novant Health Pediatrics Southpark
LBN: Novant Health Medical Group, Llc
Novant Health Pediatrics Southpark is an health care organization with primary practice located at 6324 Fairview Rd Suite 350, Charlotte NC 28210-4171. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty.
Novant Health Medical Group, Llc can be contacted via phone (704) 384-8600, or through Walton, Leea Jeanine via phone (704) 316-6081.
Contact Information
Primary practice address
6324 Fairview Rd Suite 350
Charlotte NC 28210-4171
Phone: (704) 384-8600
Fax: (704) 384-8610
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | North Carolina |
Profile Details
| NPI number | 1467490102 |
|---|---|
| LBN Legal business name | Novant Health Medical Group, Llc |
| DBA Doing business as | Novant Health Pediatrics Southpark |
| Authorized official | Walton, Leea Jeanine |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 3rd, 2006 |
| Last updated | Jun 20th, 2024 - about 5 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467490102 | NPPES |
| South Carolina | MEDICAID | NPA712 | |
| South Carolina | Other | 0273W | |
| South Carolina | MEDICAID | 890273W |
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