Novant Health Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT HEALTH MEDICAL GROUP, LLC

Practice address

9101 Monroe Rd
Suite 155
Charlotte, NC 28270-2467

Phone

(704) 384-1260

Fax

(704) 384-1289

NPI assigned

May 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leea Jeanine Walton

Title

RCS Manager

Phone

(704) 316-6081

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Novant Health Crown Point Family Physican Doing business as

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Tyler Balkenbush, MD

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1376122028

  Single Specialty

  NPD
• Brittney Chantel Cole, MD

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1265965727
  NPD
• Milton Mark Hester, M.D.

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1619962784
  NPD
• April Janlyn Corley, MD

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1871854943
  NPD (past)
• Mark O Speight, M.D.

  • Family Medicine Physician
  • Matthews, NC
  • NPI 1003801655
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1013962307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1260",
            "fax_number": "704-384-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 MONROE RD",
            "address_2": "SUITE 155",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702467",
            "telephone_number": "704-384-1260",
            "fax_number": "704-384-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890272Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0272Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Crown Point Family Physican",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Crown Point Family Physican",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group LLC
• Novant Health Medical Group LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.