Alexandra Karina McKenzie Green, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4549 Issued in SC

Practice address

1018 N Guignard Dr
Sumter, SC 29150-2423

Phone

(803) 773-5567

NPI assigned

Sep 8, 2022

Last updated

Sep 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alexandra Karina McKenzie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1396466173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N GUIGNARD DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N GUIGNARD DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502423",
            "telephone_number": "803-773-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALEXANDRA",
        "middle_name": "KARINA MCKENZIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "4549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "MCKENZIE",
            "middle_name": "KARINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sherry A. Grainger, LPN
• Grand Palace Activity Center
• Joseph P Grant, M.D.
• Jeemy D. Grate-Pearson
• Auston Hawkins Gray Jr., M.D.
• Caroline Calder Green, PA
• Crystal Bennett Green, MA, LPC-A
• Marva Sharica Green
• Norman Jarod Green
• Tiffany Green

• Physical Therapy Assistant in Sumter, SC
• Providers in Sumter, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.