NPIMap

Individual provider Active NPI

McKenzie Dickson Greene, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1154881837
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-16078 Issued in NC
Practice address
700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone
(704) 334-7800
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085006947 IL
Physician Assistant 363A00000X 0010-16078 NC Primary
Surgical Physician Assistant 363AS0400X 085006947 IL
Medical Physician Assistant 363AM0700X 085006947 IL

Addresses

Primary practice location

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone (704) 334-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, NC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190628001389 IL Practitioner - Physician Assistant 6002140746 Reassigns benefits to 1 organization
I20211112001994 IN Practitioner - Physician Assistant 6002140746 Reassigns benefits to 1 organization
I20260219004078 NC Practitioner - Physician Assistant 6002140746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

Charlotte, NC 28202
Phone (704) 362-5391

Charlotte, NC 28203
Phone (704) 362-5391

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

920 Church St N
Concord, NC 28025-2927
Phone (704) 334-7800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-16078NCMDPhysician Assistant
085006947ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Radiology P a CurrentSince Feb 2, 2026 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC Physician Assistant CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Oct 4, 2021 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Oct 4, 2021 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

9200 Calumet Ave
#300
Munster, IN 46321

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

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 11

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1154881837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MCKENZIE",
        "middle_name": "DICKSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006947",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16078",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085006947",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085006947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.