Mary Crystal Mask, CNA

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

3815 Utica Pike Jeffersonville Indiana
Jeffersonville, in, IN 47130

Phone

(502) 546-8797

NPI assigned

Jun 26, 2023

Last updated

Jun 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Crystal Mask Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1053097022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 UTICA PIKE JEFFERSONVILLE INDIANA",
            "city": "JEFFERSONVILLE, IN",
            "state": "IN",
            "postal_code": "47130",
            "telephone_number": "150-238-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 UTICA PIKE JEFFERSONVILLE INDIANA",
            "city": "JEFFERSONVILLE, IN",
            "state": "IN",
            "postal_code": "47130",
            "telephone_number": "502-546-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASK",
        "first_name": "MARY",
        "middle_name": "CRYSTAL",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MASK",
            "middle_name": "CRYSTAL",
            "credential": "CNA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.