Individual provider Active NPI

Laquinta M Mason

  • Family Nurse Practitioner
  • Fitzgerald, GA
National Provider Identifier
1053139683
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN296128 Issued in GA
Practice address
125 Benjamin H Hill Dr SW
Fitzgerald, GA 31750-8606
Phone
(229) 635-4004
NPI assigned
Oct 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN296128 GA Primary

Addresses

Primary practice location

125 Benjamin H Hill Dr SW
Fitzgerald, GA 31750-8606

Mailing address

1500 1St Ave N Unit 3
Birmingham, AL 35203-1866
Phone (205) 545-5088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241205000653 GA Practitioner - Nurse Practitioner 4587190228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Urgent Care LLCGroup PAC ID 8820305600, 171 clinicians

Practice addresses (Care Compare)

125 Benjamin H Hill Dr SW
Fitzgerald, GA 31750-8606
Phone (205) 545-5088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Sep 17, 2024 Accepting new patients
Rural Urgent Care LLC CurrentSince Sep 17, 2024 Accepting new patients
Community Care Health Network LLC CurrentSince Dec 1, 2025 Accepting new patients
Rural Urgent Care LLC PastSince Sep 28, 2021 Accepting new patients
Rural Urgent Care LLC PastSince Nov 6, 2022 Accepting new patients
Rural Urgent Care LLC PastSince Jul 7, 2024 Accepting new patients
Rural Urgent Care LLC PastSince Aug 6, 2023 Accepting new patients
Rural Urgent Care LLC PastSince Nov 22, 2020 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

3910 Washington Rd
Augusta, GA 30907
Phone (205) 644-8256

1408 Tallahassee Hwy
Ste Z
Bainbridge, GA 39819
Phone (229) 400-9033

440 US Highway 84 E
Cairo, GA 39828
Phone (229) 307-2075

3201 Macon Rd
Ste 109
Columbus, GA 31906
Phone (706) 225-8773

3615 Browns Bridge Rd
#A
Cumming, GA 30028
Phone (678) 456-4273

25 Highland Xing S
Ellijay, GA 30540
Phone (706) 273-1954

125 Benjamin H Hill Dr SW
Fitzgerald, GA 31750
Phone (229) 635-4004

162 E Jarman St
Hazlehurst, GA 31539
Phone (912) 209-0239

1028 W Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 255-4057

1245 Noah Dr
Jasper, GA 30143
Phone (706) 253-1954

2531 N Columbia St
Milledgeville, GA 31061
Phone (478) 387-2097

6999 Abercorn St
Savannah, GA 31405
Phone (912) 228-3523

14336 US Highway 19 S
Thomasville, GA 31757
Phone (229) 233-6705

1609 Norman Dr
Ste A2
Valdosta, GA 31601

Organizations & group practices 8

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": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1053139683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866",
            "telephone_number": "205-545-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BENJAMIN H HILL DR SW",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508606",
            "telephone_number": "229-635-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "LAQUINTA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN296128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

Verify at the official NPI Registry.