NPIMap

Organization Active NPI

Novant Health Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1568095081
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NOVANT HEALTH MEDICAL GROUP, LLC
Practice address
1918 Randolph Rd Ste 130
Charlotte, NC 28207-1107
Phone
(704) 316-6005
Fax
(704) 316-6006
NPI assigned
Feb 13, 2020
Organization subpart
Yes
Parent organization
NOVANT MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 130
Charlotte, NC 28207-1107

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

449 N Wendover Rd Ste A
Charlotte, NC 28211-1064
Phone (980) 302-9307

Other names 1

  • Novant Health Orthopedic Fracture Clinic 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

National Provider Directory

National Provider Directory
Part of
Presbyterian Inpt Care

Locations

12611 N Community House Rd
Charlotte, NC 28277
Phone (704) 316-1495

449 N Wendover Rd
#A
Charlotte, NC 28211
Phone (704) 316-6005

1401 Matthews Township Pkwy
Ste 210
Matthews, NC 28105
Phone (704) 358-0308

Practitioners & affiliated clinicians

Practitioners 8

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": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1568095081",
    "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": "1918 RANDOLPH RD STE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071107",
            "telephone_number": "704-316-6005",
            "fax_number": "704-316-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "449 N Wendover Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111064",
            "country_code": "US",
            "telephone_number": "980-302-9307",
            "fax_number": "704-316-9859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVANT MEDICAL GROUP, INC.",
        "enumeration_date": "2020-02-13",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "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": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Orthopedic Fracture Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Orthopedic Fracture Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.