Jonathan Lake, PAC
Jonathan Lake, PAC is a Surgical Physician Assistant in Charlotte, NC, registered under NPI 1346283801. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 225 BALDWIN AVE, Charlotte, NC 28204. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 103630 | NC | Surgical Physician Assistant primary |
| 103630 | NC | Physician Assistant |
This provider holds licence 103630 issued in NC. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Physician Assistant
- PAC ID
- 4688644354
Enrolled in Medicare 2 times, across 2 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| South Carolina | I20040729000693 | Practitioner - Physician Assistant |
| North Carolina | I20060921000560 | Practitioner - Physician Assistant |
Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. There are 2 separate enrolment records across 2 states (SC, NC). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Surgical covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363AS0400X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363AS0400X | Surgical Physician Assistant Surgical | 103630 | NC | primary |
| 363A00000X | Physician Assistant | 103630 | NC |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1346283801 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 13, 2006 |
| Last updated | Aug 6, 2025 |
| Status | Active |
| Sole proprietor | No |
| Credential | PAC |
| Practice address |
225 BALDWIN AVE Charlotte, NC 28204 (704) 376-1605 Fax (704) 335-8448 |
| Other identifiers |
P00344444
· Other |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 3 | 4 | 6 | 2 | 8 | 3 | 8 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 3 | 8 | 6 | 4 | 8 | 6 | 8 | 0 |
Sum = 69 · next multiple of 10 = 70 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.