Individual provider Active NPI

Mallory Ann Hoskins, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1811550197
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13784 Issued in NC
Practice address
16817 Marvin Rd
Charlotte, NC 28277-2196
Phone
(704) 495-6334
NPI assigned
Apr 22, 2019
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-13784 NC Primary
Medical Physician Assistant 363AM0700X 4209 SC
Specialist 174400000X 4209 SC
Dermatology Physician 207N00000X 2381 NE
Dermatology Physician 207N00000X 4209 SC

Addresses

Primary practice location

16817 Marvin Rd
Charlotte, NC 28277-2196

Mailing address

5960 Fairview Rd Ste 500
Charlotte, NC 28210-3113
Phone (704) 495-6334

Other identifiers 1

IdentifierTypeStateIssuer
$$$$$$$$$MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20211117003047 SC Practitioner - Physician Assistant 9032448139 Reassigns benefits to 1 organization
I20240112000096 NC Practitioner - Physician Assistant 9032448139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tryon Medical Partners, PLLCGroup PAC ID 7113277971, 139 clinicians

Practice addresses (Care Compare)

16817 Marvin Rd
Charlotte, NC 28277-2196
Phone (704) 495-6334

201 S College St
FL 12
Charlotte, NC 28244-0002
Phone (704) 495-6334

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4209SCMDChiropractor
2381NEMDOccupational Therapist
0010-13784NCMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: mallory.hoskins.1@17847.direct.athenahealth.com
  • Direct secure messaging: mhoskins@rockhillderm.emadirect.md

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1811550197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "704-495-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16817 MARVIN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772196",
            "telephone_number": "704-495-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSKINS",
        "first_name": "MALLORY",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13784",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "4209",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "4209",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NE",
            "license": "2381",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "4209",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.