Individual provider Active NPI

Kristin Kathleen Teague, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1164730487
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02551 Issued in NC
Practice address
325 Hawthorne LN Ste 100
Charlotte, NC 28204-2536
Phone
(704) 316-7760
Fax
(704) 316-7761
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 001002551 NC
Physician Assistant 363A00000X 0010-02551 NC Primary

Addresses

Primary practice location

325 Hawthorne LN Ste 100
Charlotte, NC 28204-2536

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

125 Queens Rd Ste 540
Charlotte, NC 28204-3215
Phone (980) 302-6560

Other identifiers 3

IdentifierTypeStateIssuer
1164730487MedicaidNC
8102004MedicaidNC
1102PAMedicaidSC

Other names 1

  • Kristin Kathleen Lang Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klang258140@direct.novanthealth.org

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
I20101116000523 NC Practitioner - Physician Assistant 8325233364 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

325 Hawthorne LN
Suite 100
Charlotte, NC 28204-2536
Phone (704) 316-7760

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

885 Summit Crossing PL
Gastonia, NC 28054-2193
Phone (704) 384-8200

885 Summit Crossing Place
Gastonia, NC 28054-2193
Phone (704) 316-4979

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-02551NCMDPhysician Assistant
001002551NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Nov 8, 2010 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 18, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 4, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 4, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 18, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Nov 8, 2010 Accepting new patients

Locations

125 Queens Rd
Ste 540
Charlotte, NC 28204
Phone (980) 302-6560

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

325 Hawthorne Ln
Ste 100
Charlotte, NC 28204
Phone (704) 316-7763

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 10

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1164730487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HAWTHORNE LN STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042536",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Queens Rd Ste 540",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043215",
            "country_code": "US",
            "telephone_number": "980-302-6560",
            "fax_number": "980-302-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "KRISTIN",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "001002551",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164730487",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102004",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1102PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klang258140@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 540",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "LANG",
            "middle_name": "KATHLEEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.