Individual provider Active NPI

Kaitlin Lyghtel, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1205422904
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013858 Issued in NC
Practice address
200 Queens Rd Ste 400
Charlotte, NC 28204-3264
Phone
(704) 333-7376
Fax
(704) 333-3397
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013858 NC Primary

Addresses

Primary practice location

200 Queens Rd Ste 400
Charlotte, NC 28204-3264

Mailing address

200 Queens Rd Ste 400
Charlotte, NC 28204-3264
Phone (704) 333-7376

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
I20210129002577 NC Practitioner - Nurse Practitioner 0345654570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Radiation Oncology Group, P.a.Group PAC ID 1254233950, 52 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 333-7376

200 Queens Rd
Charlotte, NC 28204-3264
Phone (704) 333-7376

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5013858NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Radiation Oncology Group, P.a. Radiation Oncology CurrentSince Mar 1, 2021 Accepting new patients
Radiation Oncology Centers of the Carolinas, Inc. Radiation Oncology CurrentSince Mar 1, 2021 Accepting new patients
Radiation Oncology Centers of the Carolinas, Inc. Radiation Oncology CurrentSince Mar 1, 2021 Accepting new patients

Locations

200 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (704) 765-2578

125 Queens Rd
Ste 150
Charlotte, NC 28204
Phone (980) 302-6144

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

1400 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 845-8800

Organizations & group practices 3

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 4

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": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1205422904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043264",
            "telephone_number": "704-333-7376",
            "fax_number": "704-333-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043264",
            "telephone_number": "704-333-7376",
            "fax_number": "704-333-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYGHTEL",
        "first_name": "KAITLIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.