Individual provider Active NPI

Mackenzie Elizabeth Coleman, PA-C

  • Physician Assistant
  • Matthews, NC
National Provider Identifier
1790406270
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04941 Issued in NC
Practice address
1401 Matthews Township Pkwy Ste 200
Matthews, NC 28105-5403
Phone
(704) 384-6901
Fax
(704) 384-6902
NPI assigned
Sep 5, 2022
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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 0010-04941 NC Primary

Addresses

Primary practice location

1401 Matthews Township Pkwy Ste 200
Matthews, NC 28105-5403

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

125 W Catawba Ave
Mount Holly, NC 28120-1601
Phone (704) 827-3014

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mackenziecolemanpa@gmail.com Direct

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
I20231205002848 NC Practitioner - Physician Assistant 7517327810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1401 Matthews Township Pkwy
Suite 200
Matthews, NC 28105-5403
Phone (704) 384-6901

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-04941NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Dec 12, 2025 Accepting new patients
Luke Medical Clinic, P.a. CurrentSince Sep 11, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 12, 2025 Accepting new patients

Locations

1401 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6901

1401 Matthews Township Pkwy
Ste 200
Matthews, NC 28105
Phone (704) 384-6901

125 W Catawba Ave
Mt Holly, NC 28120
Phone (704) 827-3014

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

Organizations & group practices 4

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 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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1790406270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MATTHEWS TOWNSHIP PKWY STE 200",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055403",
            "telephone_number": "704-384-6901",
            "fax_number": "704-384-6902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 W Catawba Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NC",
            "postal_code": "281201601",
            "country_code": "US",
            "telephone_number": "704-827-3014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MACKENZIE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mackenziecolemanpa@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "125 W Catawba Ave",
            "city": "Mount Holly",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281201601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.