Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jonathan L Lake, PAC

Individual provider Physician Assistant · NPI 1346283801

Jonathan L Lake, PAC is a Physician Assistant in Charlotte, North Carolina. Graduated from Medical University of South Carolina College of Medicine in 2002, 24 years ago. Practices with Atrium Health Neurospine Network LLC, a 105-clinician group. Licensed in North Carolina.

Years since qualifying
24
Trained at
Medical University of South Carolina College of Medicine
Licensed in
NC
In the registry since
2006
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone: (704) 376-1605
Fax: (704) 335-8448
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 103630 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 103630 (NC)

Record details

NPI number1346283801
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJune 13, 2006
Last updated in NPPESAugust 6, 2025
Certification dateAugust 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Atrium Health Neurospine Network Llc — 105 clinicians
Accepts Medicare assignment Not indicated
Practice locations8 on file with Medicare

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