NPIMap

Organization Active NPI

Novant Health Medical Group, LLC

  • Urology Physician
  • Lexington, NC
National Provider Identifier
1285356758
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NOVANT HEALTH MEDICAL GROUP, LLC
Practice address
106 W Medical Park Dr Ste a
Lexington, NC 27292-6854
Phone
(336) 248-4413
Fax
(336) 248-6260
NPI assigned
Sep 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

106 W Medical Park Dr Ste a
Lexington, NC 27292-6854

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Novant Health Davidson Urology- Lexington Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

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

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
34D0238429Novant Health Davidson Urology106 W Medical Park Drive Suite a, Lexington, NC 27292Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Inpt Care503 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1285356758",
    "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": "106 W MEDICAL PARK DR STE A",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926854",
            "telephone_number": "336-248-4413",
            "fax_number": "336-248-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "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": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Davidson Urology- Lexington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Davidson Urology- Lexington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.