Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Kenneth George Reardon, PA-C

Individual provider Physician Assistant · NPI 1417930074

Mr. Kenneth George Reardon, PA-C is a Physician Assistant in Charlotte, North Carolina. Qualified in 1995, 31 years ago. Practices with Orthocarolina, PA, a 301-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
31
Licensed in
NC
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2001 Randolph Rd
Charlotte, NC 28207-1215
Phone: (704) 323-2000
Fax: (704) 323-3985
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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 102013 (NC)

Record details

NPI number1417930074
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 28, 2005
Last updated in NPPESMay 12, 2010

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Orthocarolina, Pa — 301 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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