Individual provider Active NPI

Mary Ashley Pemberton, AA

  • Anesthesiologist Assistant
  • Savannah, GA
National Provider Identifier
1245549575
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
5353 Reynolds St
Savannah, GA 31405-6015
Phone
(912) 819-6172
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

5353 Reynolds St
Savannah, GA 31405-6015

Mailing address

255 W Michigan Ave
PO Box 1123
Jackson, MI 49201-2218
Phone (517) 787-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110216000308 SC Practitioner - Anesthesiology Assistant 0547456873 Reassigns benefits to 4 organizations
I20240610002334 FL Practitioner - Anesthesiology Assistant 0547456873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
Low Country Anesthesia, PAGroup PAC ID 8729063797, 62 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

805 Pamplico Hwy
Florence, SC 29505-6047
Phone (843) 674-2500

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (800) 228-0249

Hospital & facility affiliations

  • Viera Hospital Hospital, Melbourne, FL, CCN 100315
  • Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
23SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC CurrentSince Aug 1, 2025 Accepting new patients
Musc Community Physicians CurrentSince Dec 1, 2025 Accepting new patients
Cep America - Anesthesia PC CurrentSince Aug 1, 2025 Accepting new patients
Medstream Anesthesia PLLC CurrentSince Nov 29, 2017 Accepting new patients
Musc Community Physicians Current Accepting new patients
Low Country Anesthesia, PA CurrentSince Jul 1, 2024 Accepting new patients
Musc Community Physicians CurrentSince Dec 1, 2025 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiologist Assistant CurrentSince Jun 17, 2024 Accepting new patients
Brevard Physician Associates, PLLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

2627 W Eau Gallie Blvd
Ste 101
Melbourne, FL 32935
Phone (321) 802-6859

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1245549575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 REYNOLDS ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056015",
            "telephone_number": "912-819-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "MARY",
        "middle_name": "ASHLEY",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.