NPIMap

Organization Active NPI

Novant Health Medical Group, LLC

Doing business as Novant Health Carolina Womens Health Associates

  • Obstetrics & Gynecology Physician
  • China Grove, NC
National Provider Identifier
1780968982
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NOVANT HEALTH MEDICAL GROUP, LLC
Doing business as
Novant Health Carolina Womens Health Associates
Practice address
1955 S US 29 Hwy
China Grove, NC 28023-5684
Phone
(704) 855-7611
Fax
(704) 855-7612
NPI assigned
Oct 6, 2011
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

1955 S US 29 Hwy
China Grove, NC 28023-5684

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 855-7611

Other identifiers 1

IdentifierTypeStateIssuer
5918962MedicaidNC

Other names 1

  • Novant Health Carolina Womens Health Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204001028 NC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 648 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Denver, NC; High Point, NC; Huntersville, NC; Indian Trail, NC; Matthews, NC; Monroe, NC; Mooresville, NC; Salisbury, NC…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 44

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.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1780968982",
    "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": "704-855-7611",
            "fax_number": "704-855-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 S US 29 HWY",
            "city": "CHINA GROVE",
            "state": "NC",
            "postal_code": "280235684",
            "telephone_number": "704-855-7611",
            "fax_number": "704-855-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918962",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Carolina Womens Health Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Carolina Womens Health Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in China Grove, NC

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.