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

Organization Specialist · NPI 1710215256

Southpark Pediatrics, PA is a Specialist 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
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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