Individual provider Active NPI

Jaycie Williams Pate, MSN-FNP

  • Nurse Practitioner
  • Salisbury, NC
National Provider Identifier
1790542090
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5019716 Issued in NC
Practice address
825 W Henderson St
Salisbury, NC 28144-2725
Phone
(704) 637-1123
Fax
(704) 637-1214
NPI assigned
Mar 4, 2024
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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 5019716 NC Primary

Addresses

Primary practice location

825 W Henderson St
Salisbury, NC 28144-2725

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 765-5221

Other practice location 1

1035 Lincolnton Rd Ste E
Salisbury, NC 28144-6277
Phone (704) 637-1123

Other practice location 2

2915 Lyndhurst Ave
Winston Salem, NC 27103-4005
Phone (336) 765-5221

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
I20240410004171 NC Practitioner - Nurse Practitioner 2567800428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5019716NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Apr 19, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 19, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

7126 Village Medical Cir
Clemmons, NC 27012
Phone (336) 448-2427

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 316-1886

1710 Kernersville Medical Pkwy
Ste 202
Kernersville, NC 27284
Phone (336) 564-4873

1035 Lincolnton Rd
Salisbury, NC 28144
Phone (704) 638-9990

1035 Lincolnton Rd
Ste E
Salisbury, NC 28144
Phone (704) 637-1123

825 W Henderson St
Salisbury, NC 28144
Phone (704) 636-5542

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

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

2915 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 760-0558

Interoperability endpoints

  • Direct secure messaging: jwilliams662800@direct.novanthealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1790542090",
    "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",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W HENDERSON ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442725",
            "telephone_number": "704-637-1123",
            "fax_number": "704-637-1214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Lincolnton Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281446277",
            "country_code": "US",
            "telephone_number": "704-637-1123",
            "fax_number": "704-637-1214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2915 Lyndhurst Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271034005",
            "country_code": "US",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATE",
        "first_name": "JAYCIE",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "MSN-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.