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

Novant Health Medical Group, LLC

Organization Family Medicine Physician · NPI 1114105533

Novant Health Medical Group, LLC is a Family Medicine Physician in Locust, North Carolina. Licensed in North Carolina. Registered with an NPI since 2008.

Licensed in
NC
In the registry since
2008
Specialties on file
2
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

236 Market St Ste 110
Locust, NC 28097-9439
Phone: (704) 384-9590
Fax: (704) 384-9591
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (NC)
Internal Medicine Physician Taxonomy 207R00000X (NC)

Record details

NPI number1114105533
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 enumeratedFebruary 7, 2008
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024
Mailing addressPo Box 60447, Charlotte, NC 28260-0447

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