Individual provider Active NPI

Joanna McKellar, PA

  • Physician Assistant
  • North Charleston, SC
National Provider Identifier
1144986530
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4134 Issued in SC
Practice address
2695 Elms Plantation Blvd
North Charleston, SC 29406-7132
Phone
(843) 818-1181
NPI assigned
Nov 10, 2021
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4134 SC Primary

Addresses

Primary practice location

2695 Elms Plantation Blvd
North Charleston, SC 29406-7132

Mailing address

221 7TH Ave
Mount Pleasant, SC 29464-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220111001569 SC Practitioner - Physician Assistant 7911399522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Specialists of CharlestonGroup PAC ID 6002971165, 17 clinicians
Commonwealth Pain Associates PLLCGroup PAC ID 0941441919, 156 clinicians

Practice addresses (Care Compare)

2695 Elms Plantation Blvd
Suite a
North Charleston, SC 29406-7132
Phone (843) 818-1181

2695 Elms Plantation Blvd a
North Charleston, SC 29406-7132

9404 Hwy 78
Suite 100
Ladson, SC 29456-3909
Phone (502) 855-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4134SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Specialists of Charleston CurrentSince Oct 11, 2021 Accepting new patients
Pain Specialists of Charleston PA CurrentSince Oct 11, 2021 Accepting new patients

Locations

2695 Elms Plantation Blvd
Ste A
North Charleston, SC 29406
Phone (843) 818-1181

2791 Tricom St
North Charleston, SC 29406
Phone (843) 797-3711

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1144986530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 7TH AVE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294642801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 ELMS PLANTATION BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294067132",
            "telephone_number": "843-818-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELLAR",
        "first_name": "JOANNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.