{"npi":"1003966185","type":"NPI-2","status":"active","name":{"display":"Novant Health Medical Group, LLC","other":[],"organization_name":"NOVANT HEALTH MEDICAL GROUP, LLC","authorised_official":"Leea Walton"},"specialty":{"primary_taxonomy":"2080P0206X","primary_taxonomy_description":"Pediatric Gastroenterology Physician","slug":"pediatric-gastroenterology-physician","schema_org_specialty":null,"all":[{"code":"2080P0206X","description":"Pediatric Gastroenterology Physician","primary":true,"state":"NC","license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1918 RANDOLPH RD STE 210","city":"CHARLOTTE","state":"NC","postal_code":"282071109","country_code":"US","phone":"7043165060","fax":"7043165069"},{"purpose":"MAILING","street_1":"PO BOX 60447","city":"CHARLOTTE","state":"NC","postal_code":"282600447","country_code":"US","phone":"7043165060","fax":"7043165069"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"5905866","state":"NC","issuer":null},{"type_code":"01","label":"Other","value":"018WH","state":"NC","issuer":"BCBS NC"},{"type_code":"05","label":"Medicaid","value":"NPB219","state":"SC","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2007-01-11","last_updated":"2025-07-31","_meta":{"source":"NPPES","snapshot_date":"2025-07-31","doc_url":"https://findmynpi.com/api"}}