Active NPI
Patricia Kpan Yates, FNP-C
- Family Nurse Practitioner
- Charlotte, NC
National Provider Identifier
1104018969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5011578
- Practice address
- 5026 Acorn Forest LN
Charlotte, NC 28269-1732 - Phone
- (704) 599-0662
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 202489 | NC | |
| Home Health Aide | 374U00000X | 202489 | NC | |
| Family Nurse Practitioner | 363LF0000X | 5011578 | NC | Primary |
Addresses
Primary practice location
5026 Acorn Forest LN
Charlotte, NC 28269-1732
Mailing address
5026 Acorn Forest LN
Charlotte, NC 28269-1732
Phone (704) 599-0662
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5011578 | Other | NC | AANP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230124003168 | NC | Practitioner - Nurse Practitioner | 0648641936 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202489 | NC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morcom Medical Consultants, PLLC | Single Specialty | Current | Accepting new patients |
| Lifesource of North Carolina | Single Specialty | Current | Accepting new patients |
| Theoria Medical | Single Specialty | Current | Accepting new patients |
| Lifesource of North Carolina | Single Specialty | Current | Accepting new patients |
| Theoria Medical | Past | Accepting new patients |
Locations
969 Cox Rd
Gastonia, NC 28054
Phone (704) 266-8596
430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116
3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Dover, NC
- NPI 1447314075
NC, Single Specialty
-
- Internal Medicine Physician
- Wilmington, NC
- NPI 1811286156
Single Specialty
-
- Internal Medicine Physician
- Brighton, MI
- NPI 1164186946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779753600000",
"number": "1104018969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5026 ACORN FOREST LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282691732",
"telephone_number": "704-599-0662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5026 ACORN FOREST LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282691732",
"telephone_number": "704-599-0662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES",
"first_name": "PATRICIA",
"middle_name": "KPAN",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "202489",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "NC",
"license": "202489",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5011578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AANP",
"identifier": "5011578",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.