Individual provider Active NPI

Lily Rigmaiden, PA-C

  • Physician Assistant
  • Mount Pleasant, SC
National Provider Identifier
1649095969
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5515 Issued in SC
Practice address
1671 Belle Isle Ave Ste 110J
Mount Pleasant, SC 29464-8336
Phone
(678) 673-9692
Fax
(470) 300-7913
NPI assigned
Nov 21, 2024
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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 5515 SC Primary

Addresses

Primary practice location

1671 Belle Isle Ave Ste 110J
Mount Pleasant, SC 29464-8336

Mailing address

PO Box 201
Simpsonville, SC 29681-0201
Phone (303) 704-2719

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
I20250220000523 SC Practitioner - Physician Assistant 9335669472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Itrust Cares LLCGroup PAC ID 5092189712, 8 clinicians

Practice addresses (Care Compare)

117 Commons Way
Greenville, SC 29611-3850

127 Commons Way
Greenville, SC 29611-3850
Phone (864) 970-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5515SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gomed Charleston LLC CurrentSince Aug 17, 2026 Accepting new patients

Locations

1671 Belle Isle Ave
Ste 110J
Mt Pleasant, SC 29464
Phone (844) 994-6633

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22872/brand/2/csg/1/fhir/r4

Organizations & group practices 2

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 4

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": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1649095969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296810201",
            "telephone_number": "303-704-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 BELLE ISLE AVE STE 110J",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648336",
            "telephone_number": "678-673-9692",
            "fax_number": "470-300-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIGMAIDEN",
        "first_name": "LILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.