| NPI | 1114960069 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-06-14 |
| Last Updated | 2025-09-12 |
| Authorized Official | Leea Walton RCS Manager Phone: 7043166081 |
| Mailing Address | Po Box 60447 Charlotte, NC 28260-0447 United States Phone: (704) 384-6020 | Fax: (704) 384-6025 📍 View Map |
| Primary Practice Address | 1450 Matthews Township Pkwy Ste 355 Matthews, NC 28105-4300 United States Phone: (704) 384-6020 | Fax: (704) 384-6025 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | NC | 5906187 | - |
| Other (non-Medicare) | NC | 71098 | BCBS NC |
| Other (non-Medicare) | NC | CC5118 | RAILROAD MEDICARE |
| MEDICAID | SC | NPB227 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207N00000X – Dermatology | NC | - |
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About NPI 1114960069
Novant Health Medical Group, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1114960069. The primary specialty listed is Dermatology. The organization is located in Matthews, NC. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-14. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1114960069?
NPI 1114960069 belongs to Novant Health Medical Group, Llc, a Dermatology in Matthews, NC. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1114960069 active?
The current status of NPI 1114960069 in the NPPES registry is Active. The record was last updated on 2025-09-12.
What specialty is NPI 1114960069?
NPI 1114960069 is classified under the taxonomy Dermatology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1114960069?
You can verify NPI 1114960069 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1114960069?
The primary practice address on file for NPI 1114960069 is 1450 Matthews Township Pkwy Ste 355, Matthews, NC 28105-4300. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1114960069 issued?
NPI 1114960069 was first issued (enumerated) on 2006-06-14. The NPPES record was last updated on 2025-09-12.
Practice Location Map
Novant Health Medical Group, Llc is located at 1450 Matthews Township Pkwy Ste 355, Matthews, NC. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Novant Health Medical Group, Llc. All records sourced from the CMS NPPES registry.