Active NPI
Novant Health Medical Group, LLC
Doing business as Novant Health City Lake OB/GYN
- Obstetrics & Gynecology Physician
- Thomasville, NC
National Provider Identifier
1467956847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Doing business as
- Novant Health City Lake OB/GYN
- Practice address
- 1302 Lexington Ave
Thomasville, NC 27360-3419 - Phone
- (336) 475-6139
- Fax
- (336) 475-3331
- NPI assigned
- Mar 21, 2018
- Last updated
- Jun 20, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
1302 Lexington Ave
Thomasville, NC 27360-3419
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other names 1
- Novant Health City Lake OB/GYN
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0238757 | Novant Health City Lake OB/GYN - | Provider-performed microscopy | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 10
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.
-
- Clinical Social Worker
- Winston Salem, NC
- NPI 1013560309
-
- Physician Assistant
- Huntersville, NC
- NPI 1306462692
-
- Medical Physician Assistant
- Whiteville, NC
- NPI 1578329496
-
- Nurse Practitioner
- Thomasville, NC
- NPI 1114952553
-
- Nurse Practitioner
- Lexington, NC
- NPI 1669930152
-
- Obstetrics & Gynecology Physician
- Thomasville, NC
- NPI 1518498005
-
- Nurse Practitioner
- Thomasville, NC
- NPI 1376227512
-
- Advanced Practice Midwife
- Thomasville, NC
- NPI 1215009998
-
- Obstetrics & Gynecology Physician
- Thomasville, NC
- NPI 1003158775
-
- Physician Assistant
- Charlotte, NC
- NPI 1447616602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718841600000",
"number": "1467956847",
"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": "1302 LEXINGTON AVE",
"city": "THOMASVILLE",
"state": "NC",
"postal_code": "273603419",
"telephone_number": "336-475-6139",
"fax_number": "336-475-3331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-21",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"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": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Novant Health City Lake OB/GYN",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Thomasville, NC
- Novant Health Medical Group, LLC (Novant Health Psychiatric Medicine)
- Novant Health Medical Group, LLC (Novant Health Pain Management Clinic)
- Novant Health Medical Group, LLC (Novant Health Wound Care & Limb Preservation)
- Novant Health Medical Group, LLC (Novant Health Davidson Urology - Thomasville)
- Novant Health Medical Group, LLC (Novant Health Palliative Care)
- Novant Health Medical Group, LLC (Novant Health Cardiology Thomasville)
- Novant Health Medical Group, LLC (Novant Health Orthopedics & Sports Medicine)
- Novant Health Medical Group, LLC (Novant Health Pulmonary & Critical Care)
- Novant Health Medical Group, LLC (Novant Health Neurology and Sleep)
- Novant Health Medical Group, LLC (Novant Health Diabetes Management - Thomasville)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.