Maleena Elizabeth Payne, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1201 Village Harbor Dr Ste 104
Lake Wylie, SC 29710-9276

Phone

(803) 831-6859

NPI assigned

Aug 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment Care Compare group NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Clover, SC
  • NPI 1568641165
  Medicare reassignment
• Caromont Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Gastonia, NC
  • NPI 1144510207
  NPD
• Caromont Medical Group Inc

  • Surgery of the Hand (Surgery) Physician
  • Gastonia, NC
  • NPI 1922398080
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1831972173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 VILLAGE HARBOR DR STE 104",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297109276",
            "telephone_number": "803-831-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MALEENA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Nicolson, OTRL
• One Love Home Care LLC
• Pamela Corpus Paguio, OTR
• Jessica Pampalone, PHARMACIST
• Brent Matthew Parker, DPT
• Amber Marie Pederson, D.C.
• Caroline Grace Pennington
• Perfected Healthcare Services LLC
• Prestige Diabetic Supplies
• Prestige Home Health

• Physician Assistant in Lake Wylie, SC
• Providers in Lake Wylie, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.