NPIMap

Individual provider Active NPI

Cynthia Mason

  • Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1104462928
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26014958A Issued in IN
Practice address
6002 Saint Joe Center Rd
Fort Wayne, IN 46835-2503
Phone
(260) 492-2054
Fax
(260) 492-0037
NPI assigned
Nov 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26014958A IN Primary

Addresses

Primary practice location

6002 Saint Joe Center Rd
Fort Wayne, IN 46835-2503

Mailing address

6002 Saint Joe Center Rd
Fort Wayne, IN 46835-2503
Phone (260) 492-2054

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

LicenseStateTypeSpecialty
26014958AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I PastSince Dec 1, 2019 Accepting new patients
Kroger Limited Partnership I PastSince Dec 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1104462928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468352503",
            "telephone_number": "260-492-2054",
            "fax_number": "260-492-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6002 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468352503",
            "telephone_number": "260-492-2054",
            "fax_number": "260-492-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "CYNTHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26014958A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.