Individual provider Active NPI

Karen Greene, PA-C

  • Physician Assistant
  • Monroe, NC
National Provider Identifier
1174989164
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001006212 Issued in NC
Practice address
1107 Reynolds St
Monroe, NC 28112-4351
Phone
(704) 752-7575
Fax
(704) 752-7576
NPI assigned
Jan 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001006212 NC Primary

Addresses

Primary practice location

1107 Reynolds St
Monroe, NC 28112-4351

Mailing address

642 Cottonfield Cir
Waxhaw, NC 28173-9387
Phone (704) 307-3557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20160308001159 NC Practitioner - Physician Assistant 9032415617 Reassigns benefits to 1 organization
I20210913002683 SC Practitioner - Physician Assistant 9032415617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Ear Nose and Throat PAGroup PAC ID 8325946759, 9 clinicians

Practice addresses (Care Compare)

1107 Reynolds St
Monroe, NC 28112-4351
Phone (704) 752-7575

7666 Charlotte Hwy
Suite 220
Indian Land, SC 29707-0004
Phone (704) 752-7575

8035 Providence Rd
Suite 320
Charlotte, NC 28277-8910
Phone (704) 752-7575

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4096SCMDSpeech-Language Pathologist
001006212NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Ear Nose & Throat PA CurrentSince Mar 17, 2024 Accepting new patients

Locations

1107 Reynolds St
Monroe, NC 28112
Phone (704) 289-8220

7666 Charlotte Hwy
Ste 220
Indian Land, SC 29707
Phone (704) 752-7575

Organizations & group practices 2

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 1

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": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1174989164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 COTTONFIELD CIR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281739387",
            "telephone_number": "704-307-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 REYNOLDS ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124351",
            "telephone_number": "704-752-7575",
            "fax_number": "704-752-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KAREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001006212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.