NPIMap

Organization Active NPI

Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Monroe, NC
National Provider Identifier
1023216686
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NOVANT HEALTH MEDICAL GROUP, LLC
Practice address
1420 E Franklin St
Monroe, NC 28112-5160
Phone
(704) 289-8427
Fax
(704) 283-5522
NPI assigned
Jul 5, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(704) 316-6081

Practitioners 22

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0243309Novant Health Monroe Family Medical1420 East Franklin Street, Monroe, NC 28112ComplianceAug 14, 2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031121000692 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 3,607 practitioners
This NPI is an additional NPI on the enrollment
O20040204001028 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 648 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Denver, NC; High Point, NC; Huntersville, NC; Indian Trail, NC; Matthews, NC; Monroe, NC; Mooresville, NC; Salisbury, NC…

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1420 E Franklin St
Monroe, NC 28112-5160

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 289-8427

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
019J9OtherNCBCBS OF NC
5906999MedicaidNC
DG5586OtherNCRAILROAD MEDICARE

Other names 1

NPPES NPI Registry
  • Novant Health Monroe Family Medical Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2024.

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1023216686",
    "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": "704-289-8427",
            "fax_number": "704-283-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E FRANKLIN ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125160",
            "telephone_number": "704-289-8427",
            "fax_number": "704-283-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "019J9",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906999",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG5586",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Monroe Family Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Monroe Family Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

  • 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.