Taylor Amanda Tuten, PA
Individual provider Active NPI Physician Assistant · Charlotte, NC
NPI 1124741814 · NPPES record last updated Apr 29, 2026
Key facts
- NPI
- 1124741814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-15664 (NC)
- Practice address
- 10905 Providence Rd W Ste 270
Charlotte, NC 28277-1538 - Phone
- (704) 316-3410
- Fax
- (704) 316-3420
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Novant Health Medical Group, LLC
Practice addresses (Care Compare)
4741 Randolph Rd
Suite 100
Charlotte, NC 28211-2919
Phone (704) 365-6730
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221111001165 | IL | Practitioner - Physician Assistant | 2769859263 | |
| I20260515001525 | NC | Practitioner - Physician Assistant | 2769859263 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-15664 | NC | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-15664 | NC | Yes |
| Surgical Physician Assistant | 363AS0400X |
Addresses
Primary practice location
10905 Providence Rd W Ste 270
Charlotte, NC 28277-1538
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
1050 E Norris Dr Ste 3A
Ottawa, IL 61350-1646
Phone (815) 431-5746
Other providers in Charlotte, NC
- Mary Turpin
- Alexis Mae Turvey
- Sarah Turza
- Jillian R Tuso
- Shane Michael Tussey
- Tina Tuttle
- Priscilla Tutu
- Victoria Tuzzo
- Mackenzie Tuzzolo
- TVS Hearing of South Charlotte, LLC.
All providers in Charlotte, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.