Individual provider Active NPI

Daniel Mulligan Knowles, PA

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1972169373
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3240 Issued in SC
Practice address
1033 Saint Andrews Blvd
Charleston, SC 29407-7156
Phone
(843) 723-6111
NPI assigned
May 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TN
Physician Assistant 363A00000X 3240 SC Primary

Addresses

Primary practice location

1033 Saint Andrews Blvd
Charleston, SC 29407-7156

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other practice location 1

897 Von Kolnitz Rd
MT Pleasant, SC 29464-3630
Phone (843) 723-6111

Other practice location 2

3508 S Live Oak Dr Ste 200
Moncks Corner, SC 29461-8737
Phone (843) 723-6111

Other identifiers 1

IdentifierTypeStateIssuer
3363PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 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
I20190625000842 SC Practitioner - Physician Assistant 9133453186 Reassigns benefits to 3 organizations
I20251211003315 FL Practitioner - Physician Assistant 9133453186 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
Telehealth
Offers telehealth services
Group practices
Psynergy Health Med PLLCGroup PAC ID 0749714707, 35 clinicians

Practice addresses (Care Compare)

Charleston, SC 29407
Phone (407) 802-1060

1033 Saint Andrews Blvd
Charleston, SC 29407-7156
Phone (843) 534-1770

200 Callen Blvd
Suite 220
Summerville, SC 29486-2808
Phone (843) 723-6111

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

2093 Henry Tecklenburg Dr
Charleston, SC 29414-5743

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 723-6426

300 Callen Blvd
Summerville, SC 29486-2809

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 723-6426

3500 N Hwy 17
Mt Pleasant, SC 29466-9123
Phone (843) 723-6426

4901 Vineland Rd
Suite 350
Orlando, FL 32811-7192
Phone (407) 469-5088

615 Wesley Dr
Charleston, SC 29407-7274

6650 Rivers Ave
Suite 100
North Charleston, SC 29406-4809
Phone (407) 469-5088

897 Von Kolnitz Rd
Suite 101
Mt Pleasant, SC 29464-3630
Phone (843) 723-6111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3240SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Jun 1, 2023 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jun 1, 2023 Accepting new patients
Physician'S Pain and Spine Center, LLC Past Accepting new patients

Locations

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

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

3508 S Live Oak Dr
Ste 200
Moncks Corner, SC 29461
Phone (843) 578-2330

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

Interoperability endpoints

  • Direct secure messaging: dknowles1252713@direct.bsmhealth.org

Organizations & group practices 6

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": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1972169373",
    "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": "843-789-1620"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "897 Von Kolnitz Rd",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "SC",
            "postal_code": "294643630",
            "country_code": "US",
            "telephone_number": "843-723-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3508 S Live Oak Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Moncks Corner",
            "state": "SC",
            "postal_code": "294618737",
            "country_code": "US",
            "telephone_number": "843-723-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "DANIEL",
        "middle_name": "MULLIGAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3363PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.