NPIMap

Individual provider Active NPI

Kaitlan Leigh Rickett, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1851801005
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12122 Issued in NC
Practice address
101 E W T Harris Blvd
BLDG 5000 Suite #5101
Charlotte, NC 28262-3485
Phone
(704) 863-5847
NPI assigned
Oct 2, 2017
Sex
Female
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 0010-12122 NC Primary

Addresses

Primary practice location

101 E W T Harris Blvd
BLDG 5000 Suite #5101
Charlotte, NC 28262-3485

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-4490

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address krickett906793@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
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621001812 NC Practitioner - Physician Assistant 5193082121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

101 E W T Harris Blvd
5101 BLDG 5000
Charlotte, NC 28262-3581
Phone (704) 863-5847

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

2001 Vail Ave
Charlotte, NC 28207-1248
Phone (704) 304-5000

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-12122NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Jul 4, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Jul 4, 2022 Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center PastSince Nov 20, 2022 Accepting new patients

Locations

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

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

Interoperability endpoints

  • Direct secure messaging: krickett906793@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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 9

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1851801005",
    "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": "101 E W T HARRIS BLVD",
            "address_2": "BLDG 5000 SUITE #5101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-863-5847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKETT",
        "first_name": "KAITLAN",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2024-07-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krickett906793@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Bldg 5000, Suite #5101",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282623485",
            "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.