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

Kenneth James Wickey, PA

Individual provider Physician Assistant · NPI 1003506114

Kenneth James Wickey, PA is a Physician Assistant in Charlotte, North Carolina. Qualified in 2023, 3 years ago. Practices with Metrolina Nephrology Associates PA, a 86-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
3
Licensed in
NC
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3158 Freedom Dr Ste 3102
Charlotte, NC 28208-0014
Phone: (704) 332-0396
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-13919 (NC)

Record details

NPI number1003506114
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 11, 2023
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Metrolina Nephrology Associates Pa — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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