Novant Health Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVANT HEALTH MEDICAL GROUP, LLC

Doing business as

Novant Health Matthews Family Physicians

Practice address

1450 Matthews Township Pkwy
Suite 450
Matthews, NC 28105-5343

Phone

(704) 384-8480

Fax

(704) 384-8481

NPI assigned

Jun 10, 2006

Last updated

Jul 9, 2024By the provider in NPPES

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 3

Other names 1

• Novant Health Matthews Family Physicians Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aku Emefa Bedu, MD

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1942737127
  NPD
• Erica Marie Davis, DO

  • Family Medicine Physician
  • Matthews, NC
  • NPI 1073962205
  NPD
• Lilian Qushair Evans, MD

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1417165879
  NPD
• Donald Bruce Goodman Jr., MD

  • Family Medicine Physician
  • Matthews, NC
  • NPI 1912977190
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1407897119",
    "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": "704-384-8480",
            "fax_number": "704-384-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MATTHEWS TOWNSHIP PKWY",
            "address_2": "SUITE 450",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055343",
            "telephone_number": "704-384-8480",
            "fax_number": "704-384-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "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": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPA898",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC",
            "identifier": "011CA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011CA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Matthews Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Matthews Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group, LLC (Novant Health Pediatric Pulmonology)
• Novant Health Medical Group, LLC (Novant Health Bariatric Solutions)
• Novant Health Medical Group, LLC (Novant Health Orthopedics & Sports Medicine)
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC (Novant Health Elizabeth OB/GYN)
• Novant Health Medical Group, LLC (Novant Health Heart and Vascular Institute)
• Novant Health Medical Group, LLC (Novant Health Carolina Surgical)
• Novant Health Medical Group, LLC (Novant Health McKee Medical Group)
• Novant Health Medical Group, LLC (Novant Health Senior Care)
• Novant Health Medical Group, LLC (Novant Health First Charlotte Physicians Matthews)

• Family Medicine Physician in Matthews, NC
• Providers in Matthews, 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.
• 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.