Novant Health Medical Group, LLC
Organization Active NPI Obstetrics & Gynecology Physician · China Grove, NC
NPI 1780968982 · NPPES record last updated Jun 20, 2024
Key facts
- NPI
- 1780968982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP, LLC
- 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
- Organization subpart
- No
Authorized official
- Name
- Leea Jeanine Walton
- Title
- RCS Manager
- Phone
- (704) 316-6081
Practitioners 44
-
Amy Marie Allred, CNM
-
Kai Chen, MD
-
Carlin Leneave Duffy, NP, CNM
-
Mistee Laro Formica, CNM
-
Natasha Nicole Jones, CNM
-
Lindsay Vroon Lowery, CNM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5918962 | Medicaid | NC |
Other names
- Novant Health Carolina Womens Health Associates
Other providers in China Grove, NC
- Lizette Mejia-Angeles
- Akera Miller
- Ana Maria Murillo Figueroa
- Novant Health Medical Group, LLC
- Novant Health Medical Group, LLC
- Novant Medical Group, Inc.
- Novant Medical Group, Inc.
- Novant Medical Group, Inc.
- Jennifer Jean Olson
- Joe Parker
All providers in China Grove, NC · Obstetrics & Gynecology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.