Individual provider Active NPI

Monica Ann Molloy, MSN, APRN, BC, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mt Pleasant, SC
National Provider Identifier
1073795308
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3046 Issued in SC
Practice address
1470 Ben Sawyer Blvd
Waterside Medical Group
Mt Pleasant, SC 29464
Phone
(843) 972-0262
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3046 SC Primary

Addresses

Primary practice location

1470 Ben Sawyer Blvd
Waterside Medical Group
Mt Pleasant, SC 29464

Mailing address

1470 Ben Sawyer Blvd
Waterside Medical Group
Mt Pleasant, SC 29464
Phone (843) 972-0262

Other identifiers 1

IdentifierTypeStateIssuer
190166MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Carolina Health Systems PA Psychiatric/Mental Health CurrentSince Oct 20, 2012 Accepting new patients
Lowcountry Wellness Center LLC CurrentSince Sep 10, 2017 Accepting new patients

Locations

1065 NE 125th St
Ste 300
North Miami, FL 33161
Phone (305) 891-0050

1483 Tobias Gadson Blvd
Ste 107
Charleston, SC 29407
Phone (843) 402-0367

1483 Tobias Gadson Blvd
Ste 201
Charleston, SC 29407
Phone (843) 745-5153

Organizations & group practices 2

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1073795308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 BEN SAWYER BLVD",
            "address_2": "WATERSIDE MEDICAL GROUP",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-972-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 BEN SAWYER BLVD",
            "address_2": "WATERSIDE MEDICAL GROUP",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-972-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "MONICA",
        "middle_name": "ANN",
        "credential": "MSN, APRN, BC, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "3046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190166",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.