Individual provider Active NPI

Caitlyn McKenzie McInnis, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1740051002
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14615 Issued in NC
Practice address
1331 N Elm St Ste 200
Greensboro, NC 27401-6304
Phone
(336) 274-6682
Fax
(336) 274-8097
NPI assigned
Jan 15, 2024
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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 0010-14615 NC Primary

Addresses

Primary practice location

1331 N Elm St Ste 200
Greensboro, NC 27401-6304

Mailing address

PO Box 85378
Chicago, IL 60689-5378
Phone (336) 274-6682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250322000136 NC Practitioner - Physician Assistant 6406378181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians
Diagnostic Radiology and Imaging LLCGroup PAC ID 4183517097, 87 clinicians

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 274-6682

1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-7000

1248 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 274-6682

1331 N Elm St
Greensboro, NC 27401-6304
Phone (336) 274-6682

2400 W Friendly Ave
Greensboro, NC 27403-1109
Phone (336) 274-6682

315 W Wendover Ave
Greensboro, NC 27408-8401
Phone (336) 433-5000

4030 Oaks Professional Pkwy
Burlington, NC 27215-8491
Phone (336) 433-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Radiology & Imaging LLC CurrentSince Jun 1, 2025 Accepting new patients
Diagnostic Radiology & Imaging, LLC Past Accepting new patients

Locations

1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285

315 W Wendover Ave
Greensboro, NC 27408
Phone (336) 273-0530

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1740051002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85378",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895378",
            "telephone_number": "336-274-6682",
            "fax_number": "336-274-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016304",
            "telephone_number": "336-274-6682",
            "fax_number": "336-274-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "CAITLYN",
        "middle_name": "MCKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.