Individual provider Active NPI

Kazlin Mason, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Greenville, NC
National Provider Identifier
1033500558
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11124 Issued in NC
Practice address
600 Moye Blvd
Ecu Physicians Speech Language Pathology
Greenville, NC 27834-4300
Phone
(252) 744-6104
NPI assigned
Feb 6, 2015
Last updated
May 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 11124 NC Primary

Addresses

Primary practice location

600 Moye Blvd
Ecu Physicians Speech Language Pathology
Greenville, NC 27834-4300

Mailing address

PO Box 751069
Ecu Physicians
Charlotte, NC 28275-1069

Other identifiers 2

IdentifierTypeStateIssuer
1033500558MedicaidNC
19A2WOtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190510000574 VA Practitioner - Qualified Speech Language Pathologist 7719205871 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Rector & Visitors of the University of Virginia Current Accepting new patients
Rector & Visitors of the University of Virginia CurrentSince Jan 7, 2019 Accepting new patients
Rector & Visitors of the University of Virginia Speech-Language Pathologist CurrentSince Jan 7, 2019 Accepting new patients

Locations

417 Emmet St S
Charlottesville, VA 22903
Phone (434) 924-7034

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.

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1033500558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "address_2": "ECU PHYSICIANS",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MOYE BLVD",
            "address_2": "ECU PHYSICIANS SPEECH LANGUAGE PATHOLOGY",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344300",
            "telephone_number": "252-744-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "KAZLIN",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033500558",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "19A2W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.