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

Tina Marlene Ellis, PA

Individual provider Medical Physician Assistant · NPI 1053648436

Tina Marlene Ellis, PA is a Physician Assistant in North Charleston, South Carolina. Graduated from Medical University of South Carolina College of Medicine in 2009, 17 years ago. Practices with Coastal Carolina Multispecialty Associates LLC, a 48-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
17
Trained at
Medical University of South Carolina College of Medicine
Licensed in
SC
In the registry since
2009
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.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4969 Centre Pointe Dr Ste 100
North Charleston, SC 29418-6952
Phone: (843) 853-0250
Fax: (843) 606-8103
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2889 (SC)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 2889 (SC)

Record details

NPI number1053648436
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 5, 2009
Last updated in NPPESJanuary 27, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Coastal Carolina Multispecialty Associates Llc — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in North Charleston