Individual provider Active NPI

Jennifer Lee Mikoll, PA-C

  • Physician Assistant
  • Mount Pleasant, SC
National Provider Identifier
1255437547
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2231 Issued in SC
Practice address
1861 Hubbell Dr
Mount Pleasant, SC 29466-9211
Phone
(716) 418-6660
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2231 SC Primary
Physician Assistant 363A00000X 2194 MA

Addresses

Primary practice location

1861 Hubbell Dr
Mount Pleasant, SC 29466-9211

Mailing address

1861 Hubbell Dr
Mount Pleasant, SC 29466-9211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150108002117 SC Practitioner - Physician Assistant 1052593027 Reassigns benefits to 2 organizations
I20230926001354 NY Practitioner - Physician Assistant 1052593027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowcountry Oncology Associates LLCGroup PAC ID 4688113723, 13 clinicians

Practice addresses (Care Compare)

9313 Medical Plaza Dr
Suite 103
North Charleston, SC 29406-9802
Phone (843) 790-8280

Hospital & facility affiliations

  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Express - North Charleston LLC CurrentSince Aug 14, 2019 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jul 29, 2023 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jul 29, 2023 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

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.

Hospital & facility affiliations 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1255437547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 HUBBELL DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 HUBBELL DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669211",
            "telephone_number": "716-418-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLL",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2231",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "2194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.