Individual provider Active NPI

Molly Kate Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1720717549
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
29035 Issued in SC
Practice address
9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112
Phone
(843) 572-1228
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 111137 WV
Certified Registered Nurse Anesthetist 367500000X 29035 SC Primary

Addresses

Primary practice location

9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112

Mailing address

PO Box 632509
Cincinnati, OH 45263-2509
Phone (803) 765-1838

Other practice location 1

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Other practice location 2

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5431

Other identifiers 1

IdentifierTypeStateIssuer
AN4330MedicaidSC

Other names 1

  • Molly Kate Cavanaugh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918002411 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204377252 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours St Francis Xavier Hospital IncGroup PAC ID 8325008717, 202 clinicians
Trident Anesthesia Group LLCGroup PAC ID 5294631545, 121 clinicians

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-2028

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111137WVMDCritical Care Medicine Registered Nurse
29035SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Anesthesia Associates, LLC CurrentSince Aug 1, 2024 Accepting new patients
Trident Anesthesia Group, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

423 Barony St
Moncks Corner, SC 29461

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

Organizations & group practices 3

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": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1720717549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632509",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632509",
            "telephone_number": "803-765-1838",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MOLLY",
        "middle_name": "KATE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WV",
            "license": "111137",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "29035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN4330",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "CAVANAUGH",
            "middle_name": "KATE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.