Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Novant Health Medical Group, LLC

Organization Family Medicine Physician · NPI 1063771749

Novant Health Medical Group, LLC provides Family Medicine Physician services in Charlotte, North Carolina. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13460 Plaza Road Ext Ste 100
Charlotte, NC 28215-8923
Phone: (704) 316-4990
Fax: (704) 316-4998
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1063771749
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leea Walton — Rcs Manager · (704) 316-6081
Other names Novant Health Lakeside Primary Care; Novant Health Lakeside Primary Care
NPI enumeratedMay 15, 2012
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024
Mailing addressPo Box 60447, Charlotte, NC 28260-0447

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