NPIMap

Individual provider Active NPI

Molly Ann Mabry, PA-C

  • Medical Physician Assistant
  • Conway, SC
National Provider Identifier
1245012681
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5122 Issued in SC
Practice address
808 Farrar Drive
Conway, SC 29526-8747
Phone
(843) 234-8700
Fax
(843) 234-8689
NPI assigned
Oct 19, 2023
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5122 SC Primary

Addresses

Primary practice location

808 Farrar Drive
Conway, SC 29526-8747

Mailing address

300 Singleton Ridge Rd
Attention PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

5010 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579
Phone (843) 236-2700

Other practice location 2

100 62nd Ave N, Ste B
Myrtle Beach, SC 29572-7202
Phone (843) 234-8700

Other practice location 3

4022 Postal Way
Myrtle Beach, SC 29579-3537
Phone (843) 236-0000

Other identifiers 1

IdentifierTypeStateIssuer
6595PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109003338 SC Practitioner - Physician Assistant 4688025174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

1100 62ND Ave N
Myrtle Beach, SC 29572-7202

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7112

394 Singleton Ridge Rd
Conway, SC 29526-9150
Phone (843) 347-8050

4022 Postal Way
Myrtle Beach, SC 29579-3537

808 Farrar Dr
Conway, SC 29526-8747
Phone (843) 234-8700

847 Farrar Dr
Unit 2
Conway, SC 29526-8747
Phone (843) 234-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5122SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Conway Hospital, Inc. Medical CurrentSince Jan 1, 2024 Accepting new patients
Conway Hospital, Inc. Medical Past Accepting new patients

Locations

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

808 Farrar Dr
Conway, SC 29526
Phone (843) 234-8700

4022 Postal Way
Myrtle Beach, SC 29579
Phone (843) 236-0000

5010 Carolina Forest Blvd
Myrtle Beach, SC 29579
Phone (843) 236-2700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1245012681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 FARRAR DRIVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268747",
            "telephone_number": "843-234-8700",
            "fax_number": "843-234-8689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5010 Carolina Forest Blvd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295793579",
            "country_code": "US",
            "telephone_number": "843-236-2700",
            "fax_number": "843-236-2726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 62nd Ave N, Ste B",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295727202",
            "country_code": "US",
            "telephone_number": "843-234-8700",
            "fax_number": "843-234-8689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4022 Postal Way",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295793537",
            "country_code": "US",
            "telephone_number": "843-236-0000",
            "fax_number": "843-236-6191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MABRY",
        "first_name": "MOLLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "5122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6595PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.