Individual provider Active NPI

Mary Evelyn Sheckley, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1659929065
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12126 Issued in NC
Practice address
4741 Randolph Rd Ste 100
Charlotte, NC 28211-2919
Phone
(704) 365-6730
Fax
(704) 365-6731
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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 0010-12126 NC Primary

Addresses

Primary practice location

4741 Randolph Rd Ste 100
Charlotte, NC 28211-2919

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

200 Medical Park Dr
Ste 500
Concord, NC 28025-2982
Phone (704) 403-4980

Other names 1

  • Mary Evelyn Malinowski Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmalinowski1096774@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220406002791 NC Practitioner - Physician Assistant 0547656191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

4741 Randolph Rd
Charlotte, NC 28211-2919
Phone (704) 365-6730

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-12126NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Apr 12, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 16, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 16, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 12, 2025 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Northside Surgical Professional Services LLC PastSince Sep 1, 2022 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

4741 Randolph Rd
Ste 100200
Charlotte, NC 28211
Phone (704) 365-6730

200 Medical Park Dr
Ste 500
Concord, NC 28025
Phone (704) 403-1307

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: mmalinowski1096774@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: msheckley1683395@direct.novanthealth.org

Organizations & group practices 8

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 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": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1659929065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 RANDOLPH RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112919",
            "telephone_number": "704-365-6730",
            "fax_number": "704-365-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252982",
            "country_code": "US",
            "telephone_number": "704-403-4980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHECKLEY",
        "first_name": "MARY",
        "middle_name": "EVELYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmalinowski1096774@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 500",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MALINOWSKI",
            "middle_name": "EVELYN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.