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

Vidya Venkat, PA

Individual provider Physician Assistant · NPI 1104035476

Vidya Venkat, PA is a Physician Assistant in Charlotte, North Carolina. Qualified in 2004, 22 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
22
Licensed in
NC
In the registry since
2007
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

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone: (704) 510-8000
Fax: (704) 510-8006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1000 Blythe Blvd, Charlotte, NC 28203-5812 — (704) 355-2171
  • 2709 Water Ridge Pkwy, Charlotte, NC 28217-4596 — (704) 446-9173

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-01576 (NC)

Record details

NPI number1104035476
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 22, 2007
Last updated in NPPESDecember 14, 2023
Certification dateDecember 14, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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