Kao Nu Ly, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

104223 Issued in NC

Practice address

1718 E 4TH St
Suite 805
Charlotte, NC 28204-3260

Phone

(704) 376-5636

Fax

(704) 376-5933

NPI assigned

May 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073560280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 805",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043260",
            "telephone_number": "704-376-5636",
            "fax_number": "704-376-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 805",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043260",
            "telephone_number": "704-376-5636",
            "fax_number": "704-376-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "KAO NU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "104223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LW Care LLC
• Alyssa Ly Nicholson, OTD, OTR/L
• Ashley Chufa Ly, PHARMD
• Ethan Ly
• Jason Ly, DO
• Thoa Ly
• James Stephen Lye, M.D.
• Robyn L. Lyemance, CRNA
• Sherry Leigh Lyerly-Tarner, M.S., LCMHC
• Kaitlin Lyghtel, FNP

• Surgical Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Surgical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.