Individual provider Active NPI

Patricia Kpan Yates, FNP-C

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1104018969
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011578 Issued in NC
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

Updated by the provider on May 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 202489 NC
Home Health Aide 374U00000X 202489 NC
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
5011578OtherNCAANP

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
202489NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Morcom Medical Consultants, PLLC Single Specialty CurrentSince Jun 28, 2025 Accepting new patients
Lifesource of North Carolina Single Specialty CurrentSince Jun 1, 2023 Accepting new patients
Theoria Medical Single Specialty CurrentSince Jan 10, 2025 Accepting new patients
Lifesource of North Carolina Single Specialty CurrentSince Jun 1, 2023 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.

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

Verify at the official NPI Registry.