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

MS. Elisa Bennett Mauldin, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1578278404

MS. Elisa Bennett Mauldin, PA is a Physician Assistant in Williamsburg, Kentucky. Qualified in 2023, 3 years ago. Practices with Baptist Health Medical Group Inc, a 2,445-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
3
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

17 Shadowridge Dr Apt 1
Williamsburg, KY 40769-2111
Phone: (864) 325-6982
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1578278404
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 16, 2023
Last updated in NPPESOctober 17, 2023
Certification dateOctober 17, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Baptist Health Medical Group Inc — 2445 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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