Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Madeline Anne Pence, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1922774553

Madeline Anne Pence, PHYSICIANASSISTANT is a Physician Assistant in Raleigh, North Carolina. Qualified in 2021, 5 years ago. Practices with Southern Dermatology PA, a 51-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina and South Carolina.

Years since qualifying
5
Licensed in
NC, SC
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

4201 Lake Booke Trl Ste 200
Raleigh, NC 27607
Phone: (919) 782-2152
Fax: (919) 782-7929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2180 Henry Tecklenburg Dr, Charleston, SC 29414-5798 — (843) 556-8886
  • 208 Brighton Park Blvd, Summerville, SC 29486-3000 — (843) 556-8886

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5128 (SC)
Physician Assistant Taxonomy 363A00000X · Licence 0010-15512 (NC)

Record details

NPI number1922774553
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedAugust 23, 2021
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Southern Dermatology Pa — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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