Individual provider Active NPI

Molly McKnight Tappan

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1003651365
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15327 Issued in NC
Practice address
125 Queens Rd
Charlotte, NC 28204-3278
Phone
(803) 026-5009
Fax
(980) 302-6505
NPI assigned
Jun 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 0010-15327 NC Primary

Addresses

Primary practice location

125 Queens Rd
Charlotte, NC 28204-3278

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1775 N Sector Ct Ste 200
Winchester, VA 22601-2859
Phone (540) 542-6208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250529000251 NC Practitioner - Physician Assistant 6002335478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15327NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince May 9, 2025 Accepting new patients
The Presbyterian Hospital CurrentSince May 9, 2025 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

125 Queens Rd
Ste 520
Charlotte, NC 28204
Phone (980) 302-6500

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

Interoperability endpoints

  • Direct secure messaging: mtappan1684155@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1003651365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043278",
            "telephone_number": "803-026-5009",
            "fax_number": "980-302-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 N Sector Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012859",
            "country_code": "US",
            "telephone_number": "540-542-6208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAPPAN",
        "first_name": "MOLLY",
        "middle_name": "MCKNIGHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.