Individual provider Active NPI

Peter Kankaka Nkyesiga, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1316198229
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03018 Issued in NC
Practice address
9332 S Tryon St
Charlotte, NC 28273-3108
Phone
(704) 587-6700
NPI assigned
Oct 9, 2008
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03018 NC Primary

Addresses

Primary practice location

9332 S Tryon St
Charlotte, NC 28273-3108

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

7810 Providence Rd
Ste 102
Charlotte, NC 28226-2954
Phone (704) 543-6636

Other practice location 2

704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715-8906
Phone (704) 667-3380

Other practice location 3

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

Other practice location 4

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269-2206
Phone (704) 863-9930

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pnkyesiga499994@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120904000528 NC Practitioner - Physician Assistant 2466511829 Reassigns benefits to 2 organizations
I20160920002666 SC Practitioner - Physician Assistant 2466511829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

1010 E Dixon Blvd
Shelby, NC 28152-6838
Phone (980) 487-2700

10210 Couloak Dr
Suite E
Charlotte, NC 28216-7695
Phone (704) 801-2000

1090 NE Gateway CT NE
Suite 202
Concord, NC 28025-2423
Phone (704) 403-9050

11115 Golf Links Dr
Suite B
Charlotte, NC 28277-7827
Phone (704) 667-0080

119 Market Place Ave
Suite D
Mooresville, NC 28117-9157
Phone (704) 801-9140

12016 Lemmond Farm Dr
Charlotte, NC 28227-8353

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

1426 E Morehead St
Charlotte, NC 28204-2926
Phone (704) 446-6090

1656 Riverchase Blvd
Suite 1800
Rock Hill, SC 29732-0282
Phone (803) 909-1850

1802 E Main St
Lincolnton, NC 28092-3915
Phone (980) 212-2610

2041 S Blvd
Suite 100
Charlotte, NC 28203-5775
Phone (704) 304-0140

3320 Robinwood Rd
Suite 100
Gastonia, NC 28054-6689
Phone (980) 487-2930

340 Jake Alexander Blvd W
Suite 105
Salisbury, NC 28147-1364
Phone (704) 403-6240

420 Park St
Belmont, NC 28012-3393
Phone (704) 631-1820

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

5727 Prosperity Crossing Dr
Suite 1100
Charlotte, NC 28269-5604
Phone (704) 863-9930

6030 W Hwy 74
Indian Trail, NC 28079-3469

613 E Roosevelt Blvd
Monroe, NC 28112-5124
Phone (704) 283-8193

703 Leonard Ave
Albemarle, NC 28001-5257
Phone (704) 550-0050

704 Gold Hill Rd
Fort Mill, SC 29715-8906
Phone (803) 835-0420

7810 Providence Rd
Charlotte, NC 28226-2954
Phone (704) 543-6636

8815 Christenbury Pkwy
Suite 30
Concord, NC 28027-0261
Phone (704) 403-8810

9325 JW Clay Blvd
Suite 221
Charlotte, NC 28262-5411
Phone (704) 863-9050

9332 S Tryon St
Charlotte, NC 28273-3108
Phone (704) 587-6700

9623 Redstone Dr
Suite 300
Indian Land, SC 29707-5407
Phone (704) 667-4840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4285AZMDClinical Psychologist
0010-03018NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince May 28, 2012 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 28, 2012 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 19, 2016 Accepting new patients
Union Urgent Care LLC Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269
Phone (704) 863-9930

7810 Providence Rd
Ste 102
Charlotte, NC 28226
Phone (704) 393-4808

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

1090 NE Gateway Ct NE
Ste 202
Concord, NC 28025
Phone (704) 403-9050

12905 Rosedale Hill Ave
Huntersville, NC 28078
Phone (704) 801-1000

332 N Trade St
#1100
Matthews, NC 28105
Phone (704) 512-6850

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715
Phone (704) 667-3380

Interoperability endpoints

  • Direct secure messaging: pnkyesiga499994@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1316198229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 S TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282733108",
            "telephone_number": "704-587-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-543-6636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 Gold Hill Rd",
            "address_2": "Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297158906",
            "country_code": "US",
            "telephone_number": "704-667-3380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5717 Albemarle Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282121634",
            "country_code": "US",
            "telephone_number": "704-563-2150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5727 Prosperity Crossing Dr",
            "address_2": "Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692206",
            "country_code": "US",
            "telephone_number": "704-863-9930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NKYESIGA",
        "first_name": "PETER",
        "middle_name": "KANKAKA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-09",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pnkyesiga499994@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "9332 S Tryon St",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282733108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.