Individual provider Active NPI

Mary Virginia Girardeau Lucas, APRN, FNP-C, PMHNP

  • Family Nurse Practitioner
  • Walterboro, SC
National Provider Identifier
1255732798
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19050 Issued in SC
Practice address
401 Witsell St
Walterboro, SC 29488-3052
Phone
(843) 549-5546
NPI assigned
Sep 15, 2014
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19050 SC Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 19050 SC

Addresses

Primary practice location

401 Witsell St
Walterboro, SC 29488-3052

Mailing address

2030 Powers Ferry Rd SE
Suite 120
Atlanta, GA 30339-2823
Phone (678) 801-2313

Other practice location 1

1483 Tobias Gadson Blvd Ste 201
Charleston, SC 29407-4796
Phone (843) 745-5153

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
I20141209000209 SC Practitioner - Nurse Practitioner 9234451923 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Compass Carolina Health Systems PAGroup PAC ID 7214084870, 6 clinicians
Lowcountry Urgent Care LLCGroup PAC ID 9739210337, 81 clinicians

Practice addresses (Care Compare)

1483 Tobias Gadson Blvd
Suite 201
Charleston, SC 29407-4796
Phone (843) 745-5153

182 C Sea Island Pkwy
Beaufort, SC 29907-1503
Phone (843) 322-1933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19050SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Urgent Care LLC CurrentSince Nov 5, 2018 Accepting new patients
Compass Carolina Health Systems PA Family CurrentSince Jan 2, 2025 Accepting new patients
Sea Island Medical Care CurrentSince Apr 1, 2019 Accepting new patients
Lowcountry Wellness Center LLC CurrentSince Jan 2, 2025 Accepting new patients
Providence Care LLC PastSince Sep 6, 2011 Accepting new patients

Locations

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

182C Sea Island Pkwy
Beaufort, SC 29907
Phone (843) 322-1933

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

2114 Highway 41
Ste 105
Mt Pleasant, SC 29466
Phone (843) 388-9000

Interoperability endpoints

  • Direct secure messaging: mary.lucas@115443077021700.direct.elationemr.com

Organizations & group practices 5

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1255732798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 POWERS FERRY RD SE",
            "address_2": "SUITE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392823",
            "telephone_number": "678-801-2313",
            "fax_number": "844-249-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WITSELL ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294883052",
            "telephone_number": "843-549-5546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1483 Tobias Gadson Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294074796",
            "country_code": "US",
            "telephone_number": "843-745-5153",
            "fax_number": "305-891-4228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "MARY VIRGINIA",
        "middle_name": "GIRARDEAU",
        "credential": "APRN, FNP-C, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19050",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "19050",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

Verify at the official NPI Registry.