Active NPI
Lyle Beyer Mason, M.D.
- Pediatric Orthopaedic Surgery Physician
- Bountiful, UT
National Provider Identifier
1104027234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Orthopaedic Surgery Physician
- License
- 162465-1205
- Practice address
- 1708 Stone Ridge Cir
Bountiful, UT 84010-1033 - Phone
- (801) 295-7604
- Fax
- (801) 295-7604
- NPI assigned
- May 29, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | 162465-1205 | UT | Primary |
Addresses
Primary practice location
1708 Stone Ridge Cir
Bountiful, UT 84010-1033
Mailing address
1708 Stone Ridge Cir
Bountiful, UT 84010-1033
Phone (801) 295-7604
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162465-1205 | UT | MD | Pediatric Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104027234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1708 STONE RIDGE CIR",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840101033",
"telephone_number": "801-295-7604",
"fax_number": "801-295-7604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 STONE RIDGE CIR",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840101033",
"telephone_number": "801-295-7604",
"fax_number": "801-295-7604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "LYLE",
"middle_name": "BEYER",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207XP3100X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
"state": "UT",
"license": "162465-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bountiful, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.