Active NPI
Stephen Mason
- Optician
- Port Charlotte, FL
National Provider Identifier
1093907784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- OE702
- Practice address
- 4265 Tamiami TRL
Suite G
Port Charlotte, FL 33980-2152 - Phone
- (941) 625-6602
- Fax
- (941) 625-0021
- NPI assigned
- Aug 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | OE702 | FL | Primary |
Addresses
Primary practice location
4265 Tamiami TRL
Suite G
Port Charlotte, FL 33980-2152
Mailing address
4265 Tamiami TRL
Suite G
Port Charlotte, FL 33980-2152
Phone (941) 625-6602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE702 | FL | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Optical LLC | Optician | Past | Accepting new patients |
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.
-
- Optician
- Port Charlotte, FL
- NPI 1639361322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193011200000",
"number": "1093907784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4265 TAMIAMI TRL",
"address_2": "SUITE G",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802152",
"telephone_number": "941-625-6602",
"fax_number": "941-625-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4265 TAMIAMI TRL",
"address_2": "SUITE G",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802152",
"telephone_number": "941-625-6602",
"fax_number": "941-625-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "STEPHEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-16",
"last_updated": "2007-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "OE702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.