Organization Active NPI

Sourwood Pediatrics, PLLC

  • Pediatrics Physician
  • Black Mountain, NC
National Provider Identifier
1285594572
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOURWOOD PEDIATRICS, PLLC
Practice address
3176 US Highway 70 W
Black Mountain, NC 28711-5526
Phone
(828) 419-0483
Fax
(828) 740-2914
NPI assigned
Nov 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Nicole Kristine Groves, MDNPI 1295718708
Title
Physician
Phone
(828) 707-6323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3176 US Highway 70 W
Black Mountain, NC 28711-5526

Mailing address

3176 US Highway 70 W
Black Mountain, NC 28711-5526
Phone (828) 419-0483

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
34D2330891Sourwood Pediatrics, PLLC3176 US 70 Hwy, Black Mountain, NC 28711Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory

Locations

3176 US Highway 70 W
Black Mountain, NC 28711
Phone (828) 419-0483

Practitioners & affiliated clinicians

Practitioners 1

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": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1285594572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3176 US HIGHWAY 70 W",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287115526",
            "telephone_number": "828-419-0483",
            "fax_number": "828-740-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3176 US HIGHWAY 70 W",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287115526",
            "telephone_number": "828-419-0483",
            "fax_number": "828-740-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURWOOD PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "GROVES",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "828-707-6323",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.