NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
NPI 1386019891
Pediatrics - Adolescent Medicine in Waxhaw, NC
NPI Status: Active since December 09, 2015
Contact Information
3614 PROVIDENCE RD S
SUITE 101
WAXHAW, NC
ZIP 28173
Phone: (704) 384-8460
Fax: (704) 384-8465
- Organization
- Pediatrics
- Adolescent Medicine
- Accepts Insurance
- CLIA Number: 34D2194580
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-16-2026
About NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Novant Health Child And Adolescent Medical Group, a pediatrician established in Waxhaw, North Carolina operating as a Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1386019891 assigned on December 2015. The practitioner's primary taxonomy code is 2080A0000X. The provider is registered as an organization and their NPI record was last updated one year ago. Novant Health Child And Adolescent Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Novant Health Child And Adolescent Medical Group. The authorized official of this NPI record is Leea Jeanine Walton (Rcs Manager)
- NPI
- 1386019891
- Provider Legal Name
- NOVANT HEALTH MEDICAL GROUP, LLC
- Other Organization Name
- NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3614 PROVIDENCE RD S SUITE 101 WAXHAW, NC 28173
- Location Phone
- (704) 384-8460
- Location Fax
- (704) 384-8465
- Mailing Address
- PO BOX 60447 CHARLOTTE, NC 28260
- Mailing Phone
- (704) 384-7840
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-09-2015
- Last Update Date
- 06-20-2024
- Code Navigator
A pediatrician like Novant Health Child And Adolescent Medical Group is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard | Nationwide Doctors - PPO
- Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Standard | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with Novant Health - EPO
- Blue Home Bronze Standard | with Novant Health - EPO
- Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with Novant Health - EPO
- Blue Home Gold Standard | with Novant Health - EPO
- Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Novant Health - EPO
- Blue Home Silver Standard | with Novant Health - EPO
- Blue Value Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
- Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors - POS
- Blue Value Bronze Standard | Limited Statewide Doctors - POS
- Connect Bronze 5500 Indiv Med Deductible - HMO
- Connect Bronze 6500 Indiv Med Deductible - HMO
- Connect Bronze CMS Standard - HMO
- Connect Gold CMS Standard - HMO
- Connect Silver 3500 Indiv Med Deductible - HMO
- Connect Silver 4400 Indiv Med Deductible - HMO
- Connect Silver CMS Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2194580
- Facility Type
- Physician Office
- Certificate Effective Date
- January 17, 2024
- Certificate Expiration Date
- January 16, 2026
- Laboratory Director
- LORI YANCHIK-CASTRO
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Novant Health Child And Adolescent Medical Group after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Reviews for NOVANT HEALTH CHILD AND ADOLESCENT MEDICAL GROUP
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 8 | 6 | 0 | 1 | 9 | 8 | 9 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 16 | 6 | 0 | 1 | 18 | 8 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 6 + 6 + 0 + 1 + 1 + 8 + 8 + 1 + 8 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1386019891 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1275837411 | NOVANT MEDICAL GROUP, INC Organization | Orthopaedic Surgery | 3614 PROVIDENCE RD S SUITE 200 WAXHAW, NC 28173 (704) 367-4800 |
| 1902232143 | DR. CASSIE LYNNAE LINKER BOLAND PHARMD Individual | Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist) | 3614 PROVIDENCE RD S STE 200 WAXHAW, NC 28173 (704) 384-8640 |
| 1679535652 | SHERRY DEMAISON FNP Individual | Nurse Practitioner | 3614 PROVIDENCE RD S SUITE 200 WAXHAW, NC 28173 (704) 384-8640 |
| 1497979611 | DR. ROBERT MALECKI M.D. Individual | Family Medicine | 3614 PROVIDENCE RD S SUITE 200 WAXHAW, NC 28173 (704) 384-8640 |
| 1215146535 | MR. ANTHONY Q. WALKER PHYSICAL THERAPIST Individual | Physical Therapist | 3614 PROVIDENCE RD S SUITE 200 WAXHAW, NC 28173 (704) 384-8640 |
| 1568400729 | NOVANT HEALTH MEDICAL GROUP, LLC Organization | Family Medicine | 3614 PROVIDENCE RD S SUITE 100 WAXHAW, NC 28173 (704) 384-8640 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386019891, enumerated in the NPI registry as an "organization" on December 09, 2015
The provider is located at 3614 Providence Rd S Suite 101 Waxhaw, Nc 28173 and the phone number is (704) 384-8460
This medical organization specializes in Pediatrics with taxonomy code 2080A0000X with a focus in Adolescent Medicine
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC and Cigna. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 34D2194580 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on December 09, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.