Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Gilead Road Pediatrics & Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
9615 KINCEY AVENUE, SUITE 100, HUNTERSVILLE, NC 28078-9140
(704) 316-5635
(704) 316-5640
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 316-5640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NC
208000000X
Pediatrics Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017F5
BCBS-NC
NC
05
—
5902021
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
Enumeration date
05/16/2006
Last updated
06/20/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up