Individual provider Active NPI

Richard G Mason, D.C.

  • Chiropractor
  • Fishers, IN
National Provider Identifier
1043391634
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002072A Issued in IN
Practice address
11580 Overlook Dr
200
Fishers, IN 46037-4212
Phone
(317) 577-9558
Fax
(317) 577-9559
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002072A IN Primary

Addresses

Primary practice location

11580 Overlook Dr
200
Fishers, IN 46037-4212

Mailing address

11580 Overlook Dr
200
Fishers, IN 46037-4212
Phone (317) 577-9558

Other identifiers 1

IdentifierTypeStateIssuer
000000298183OtherINANTHEM BC BS IN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000509 IN Practitioner - Chiropractic 2365412525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11580 Overlook Dr
Suite 200
Fishers, IN 46037-4221
Phone (317) 577-9558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002072AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
MCHC, PC Chiropractor CurrentSince Oct 8, 2003 Accepting new patients

Locations

11580 Overlook Dr
Ste 200
Fishers, IN 46037
Phone (317) 577-9558

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1043391634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11580 OVERLOOK DR",
            "address_2": "200",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374212",
            "telephone_number": "317-577-9558",
            "fax_number": "317-577-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11580 OVERLOOK DR",
            "address_2": "200",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374212",
            "telephone_number": "317-577-9558",
            "fax_number": "317-577-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "RICHARD",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002072A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS IN",
            "identifier": "000000298183",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.