NPIMap

Organization Active NPI

Novant Health Medical Group, LLC

Doing business as Novant Health Orthopedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Salisbury, NC
National Provider Identifier
1770827388
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NOVANT HEALTH MEDICAL GROUP, LLC
Doing business as
Novant Health Orthopedics & Sports Medicine
Practice address
810 Mitchell Ave
Salisbury, NC 28144-6253
Phone
(704) 216-5633
Fax
(704) 639-0785
NPI assigned
Nov 20, 2012
Last updated
Jul 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Leea Jeanine Walton
Title
Edi Manager
Phone
(704) 316-6081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

810 Mitchell Ave
Salisbury, NC 28144-6253

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 216-5633

Other practice location 1

1035 Lincolnton Rd Ste F
Salisbury, NC 28144-6277
Phone (704) 261-5633

Other practice location 2

810 Mitchell Ave
Salisbury, NC 28144-6253
Phone (704) 216-5633

Other identifiers 1

IdentifierTypeStateIssuer
5922129MedicaidNC

Other names 1

  • Novant Health Orthopedics & Sports Medicine 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

Locations

1035 Lincolnton Rd
Ste F
Salisbury, NC 28144
Phone (704) 216-5633

810 Mitchell Ave
Salisbury, NC 28144
Phone (704) 216-2633

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1770827388",
    "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": "704-216-5633",
            "fax_number": "704-639-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 MITCHELL AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446253",
            "telephone_number": "704-216-5633",
            "fax_number": "704-639-0785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Lincolnton Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281446277",
            "country_code": "US",
            "telephone_number": "704-261-5633",
            "fax_number": "704-639-0785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Mitchell Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281446253",
            "country_code": "US",
            "telephone_number": "704-216-5633",
            "fax_number": "704-639-0785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "EDI MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5922129",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Orthopedics & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Orthopedics & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.