Novant Health Waxhaw Family & Sports Medicine
LBN: Novant Health Medical Group, Llc
Novant Health Waxhaw Family & Sports Medicine is an health care organization with primary practice located at 3614 Providence Rd S Suite 100, Waxhaw NC 28173-6309. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Novant Health Medical Group, Llc can be contacted via phone (704) 384-8640, or through Walton, Leea Jeanine via phone (704) 316-6081.
Contact Information
Primary practice address
3614 Providence Rd S Suite 100
Waxhaw NC 28173-6309
Phone: (704) 384-8640
Fax: (704) 384-8650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X |
Profile Details
| NPI number | 1568400729 |
|---|---|
| LBN Legal business name | Novant Health Medical Group, Llc |
| DBA Doing business as | Novant Health Waxhaw Family & Sports Medicine |
| Authorized official | Walton, Leea Jeanine |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Jul 9th, 2024 - about last year |
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 | 1568400729 | NPPES |
| North Carolina | Other | 0276T | BCBS |
| North Carolina | MEDICAID | NPA885 | BCBS |
| North Carolina | Other | CC5118 | BCBS |
| North Carolina | MEDICAID | 890276T | BCBS |
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