Individual provider Active NPI

Katelyn Marie Watkins, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1659960847
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10914 Issued in NC
Practice address
2001 Vail Ave Ste 200
Charlotte, NC 28207-1222
Phone
(704) 323-3668
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 0010-10914 NC Primary

Addresses

Primary practice location

2001 Vail Ave Ste 200
Charlotte, NC 28207-1222

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2237

Other identifiers 2

IdentifierTypeStateIssuer
1659960847MedicaidNC
5150PAMedicaidSC

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
I20210323002562 NC Practitioner - Physician Assistant 1456768282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

1915 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 323-2282

2001 Vail Ave
Suite 200
Charlotte, NC 28207-1219
Phone (704) 323-2000

9101 Pineville Matthews Rd
Suite D
Pineville, NC 28134-8826
Phone (704) 323-3300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-10914NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Orthopaedic Clinic, PA CurrentSince Feb 22, 2021 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Jun 6, 2022 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Jun 6, 2022 Accepting new patients

Locations

2001 Vail Ave
Ste 200
Charlotte, NC 28207
Phone (704) 323-2564

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

Interoperability endpoints

  • Direct secure messaging: katelyn.watkins.p1@direct.capefearortho.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1659960847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071222",
            "telephone_number": "704-323-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659960847",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5150PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.