DR. MACKENZY GREEN (DPT) – Physical Therapist, NPI 1124877238

DR. MACKENZY GREEN (DPT) is a healthcare provider. based in Fortson, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. The NPI Number for DR. MACKENZY GREEN (DPT) is 1124877238

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. MACKENZY GREEN (DPT)
NPI
1124877238
Phone
Not provided
Address
PO BOX 370
Enumeration Date
13 May 2024
Last Update Date
21 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7049654114
Graduation Year
2024 (2 years ago)
PAC ID
1658810445
Group Practice PAC ID
3274819644
Professional Enrollment ID
I20240823003799
Address ID
FL328275811OR6775XTERX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:2State licenses:0Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for DR. MACKENZY GREEN (DPT)

  • PO BOX 370

    FORTSON, GA 318080370

    Phone:

    Type: Mailing

  • 6775 CHOPRA TER STE 300

    ORLANDO, FL 328275811

    Phone: (407) 965-4114

    Fax: (833) 408-2573

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240823003799IPhysical Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31808)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274819644View full group profile
NameSpecialtyState
Orthopedic SurgeryFL
Orthopedic SurgeryGA
-FL
Orthopedic SurgeryGA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Can I use this page to confirm DR. MACKENZY GREEN (DPT)'s NPI?
Yes. DR. MACKENZY GREEN (DPT) is listed with NPI 1124877238 in the public NPI dataset.
Is DR. MACKENZY GREEN (DPT) listed as active for patients and plans?
The listing shows DR. MACKENZY GREEN (DPT) as active in the NPI system.
What is DR. MACKENZY GREEN (DPT)'s primary classification?
Physical Therapist is the headline specialty for DR. MACKENZY GREEN (DPT) here. Clinical services aligned with this taxonomy classification.
Where should I expect DR. MACKENZY GREEN (DPT) on a map?
Expect Fortson, Georgia as a primary anchor for DR. MACKENZY GREEN (DPT) unless the record lists multiple sites.
Why does DR. MACKENZY GREEN (DPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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