Lila T Divine, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-14463 Issued in NC

Practice address

10905 Providence Rd W Ste 270
Charlotte, NC 28277-1538

Phone

(704) 316-3410

Fax

(704) 316-3420

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Merit-based Incentive Payment System (MIPS)

Final score

89.24 of 100Reported as group

Quality

62.82

Improvement activities

40

Cost

83.93

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lila.divine.1@20474.direct.athenahealth.com
• Direct secure messaging: ldivine1715710@direct.novanthealth.org
• Direct secure messaging: casacolina@direct.casacolina.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Premier Orthopaedic Trauma Specialists, PMC

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1407304439
  Medicare reassignment
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1487297958
  NPD
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  NPD
• Sports Medicine and Orthopaedic Institute

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Victorville, CA
  • NPI 1669993218
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Ballantyne Medical Center LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020
  Care Compare affiliation
• Novant Health Matthews Medical Center LLC

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1043883093",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 PROVIDENCE RD W STE 270",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282771538",
            "telephone_number": "704-316-3410",
            "fax_number": "704-316-3420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24331 El Toro Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Laguna Woods",
            "state": "CA",
            "postal_code": "926373116",
            "country_code": "US",
            "telephone_number": "949-586-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVINE",
        "first_name": "LILA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60085",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Nurse Consultant LLC
• Divine Purpose Legacy Group, Inc
• Divine Step ABA NC LLC
• Divine Wisdom Care Inc
• Amelia Divine
• Margaret Mary Divish, MD
• Dixon & Mathew Group LLC
• Dixon Family Services and Support
• Dixon Speech Solutions
• Shayna Dixon-Thompson

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.