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

Southpark Pediatrics, PA

Organization Specialist · NPI 1710215256

Southpark Pediatrics, PA provides Specialist services in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2009.

Licensed in
NC
In the registry since
2009
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4601 Park Rd Ste 100
Charlotte, NC 28209-3239 Not confirmed with CMS for 16 years — call before visiting
Phone: (704) 522-6656
Fax: (704) 522-6665
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 9501464 (NC)

Record details

NPI number1710215256
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leslie Brown — Practice Administrator · (704) 896-9830
NPI enumeratedNovember 20, 2009
Last updated in NPPESNovember 20, 2009
Mailing address4601 Park Rd, Suite 100, Charlotte, NC 28209-3239

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