OrganizationActive
Novant Health Medical Group, LLC
NPI 1639695133 · Pediatric Sports Medicine Physician · Charlotte, NC
Provider details
- NPI number
- 1639695133
- Entity type
- Organization
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Leea Walton, Edi Manager(704) 316-6081
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
201 Queens Rd
Charlotte, NC 28204
Phone: (704) 316-1070
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 60447
Charlotte, NC 28260-0447
Other names (DBA / former)
- Doing business as
- Novant Health Pediatric Sports Medicine
- Doing business as
- Novant Health Pediatric Sports Medicine
Additional practice locations (3)
- 1918 Randolph Rd Ste 100Charlotte, NC 28207-1107Phone: (704) 384-7834
- 5370 Ridge RdCharlotte, NC 28269-2298Phone: (704) 316-1020
- 1401 Matthews Township Pkwy Ste 100Matthews, NC 28105-5403Phone: (704) 316-1070
Registry dates
- Enumerated
- 2017-08-16
- Last updated
- 2024-07-11
- Certified
- 2024-07-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.