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

MS. Lila T Divine, PA

Individual provider Physician Assistant · NPI 1043883093

MS. Lila T Divine, PA is a Physician Assistant in Charlotte, North Carolina. Qualified in 2019, 7 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and North Carolina.

Years since qualifying
7
Licensed in
CA, NC
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

10905 Providence Rd W Ste 270
Charlotte, NC 28277-1538
Phone: (704) 316-3410
Fax: (704) 316-3420
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 24331 El Toro Rd Ste 200, Laguna Woods, CA 92637-3116 — (949) 586-3200

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-14463 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 60085 (CA)

Record details

NPI number1043883093
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 19, 2021
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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