Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Novant Medical Group, Inc

Organization Pediatric Gastroenterology Physician · NPI 1013453604

Novant Medical Group, Inc provides Pediatric Gastroenterology Physician services in Charlotte, North Carolina. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11840 Southmore Dr Ste 200
Charlotte, NC 28277-4466
Phone: (704) 316-5060
Fax: (704) 316-5069
Show map & directions

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

Specialties & licences

Pediatric Gastroenterology Physician (primary) Taxonomy 2080P0206X

Record details

NPI number1013453604
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shala Davis — Rcs Manager · (704) 303-7517
Other names Novant Health Pediatric Gastroenterology; Novant Health Pediatric Gastroenterology
NPI enumeratedJanuary 6, 2017
Last updated in NPPESAugust 16, 2021
Certification dateAugust 16, 2021
Mailing addressPo Box 60447, Charlotte, NC 28260-0447

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