Individual provider Active NPI

Mary Nichols Lollis, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1821888546
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1033 Saint Andrews Blvd
Charleston, SC 29407-7156
Phone
(843) 723-6111
Fax
(843) 727-2973
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 Primary

Addresses

Primary practice location

1033 Saint Andrews Blvd
Charleston, SC 29407-7156

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

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
I20251105002130 SC Practitioner - Physician Assistant 7911497367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians

Practice addresses (Care Compare)

1033 Saint Andrews Blvd
Charleston, SC 29407-7156
Phone (843) 723-6111

Hospital & facility affiliations

  • Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110
  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
  • Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
  • Roper Hospital Hospital, Charleston, SC, CCN 420087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6034SCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Nov 3, 2025 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Nov 3, 2025 Accepting new patients
Roper St. Francis Specialty Physicians Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

615 Wesley Dr
Ste 320
Charleston, SC 29407
Phone (843) 571-2939

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

2093 Henry Tecklenburg Dr
Ste 307E
Charleston, SC 29414
Phone (843) 207-1760

1033 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 534-1770

897 Von Kolnitz Rd
Ste 101
Mt Pleasant, SC 29464
Phone (843) 534-1770

3500 N Highway 17
Fl 1
Mt Pleasant, SC 29466

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

200 Callen Blvd
Ste 220
Summerville, SC 29486
Phone (843) 534-1770

Interoperability endpoints

  • Direct secure messaging: mlollis3073308@direct.bsmhealth.org

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 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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1821888546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077156",
            "telephone_number": "843-723-6111",
            "fax_number": "843-727-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOLLIS",
        "first_name": "MARY NICHOLS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.