Individual provider Active NPI

Tamarah Mason, CRNP

  • Family Nurse Practitioner
  • Selma, AL
National Provider Identifier
1104867837
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-049707 Issued in AL
Practice address
203 Vaughan Memorial Dr
Selma, AL 36701-6950
Phone
(334) 375-8007
Fax
(334) 526-1849
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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 1-049707 AL Primary

Addresses

Primary practice location

203 Vaughan Memorial Dr
Selma, AL 36701-6950

Mailing address

PO Box 570
Selma, AL 36702-0570
Phone (334) 375-8007

Other identifiers 4

IdentifierTypeStateIssuer
630902049MedicaidAL
630904049MedicaidAL
630900049MedicaidAL
511-52699OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070917000043 AL Practitioner - Nurse Practitioner 1153415542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Selma Family Care PCGroup PAC ID 1951654763, 3 clinicians

Practice addresses (Care Compare)

203 Vaughan Memorial Dr
Selma, AL 36701-6950
Phone (334) 375-8007

Hospital & facility affiliations

  • Amedisys Home Health of Selma Home health agency, Selma, AL, CCN 017320
  • Vaughan Regional Medical Center Parkway Campus Hospital, Selma, AL, CCN 010118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Selma Family Care PC CurrentSince Jul 1, 2018 Accepting new patients
Vaughan Physician Practices LLC CurrentSince Sep 2, 2014 Accepting new patients
Vaughan Physician Practices, LLC CurrentSince Sep 2, 2014 Accepting new patients
Vaughan Physician Practices LLC Past Accepting new patients
Vaughan Physician Practices LLC Past Accepting new patients

Locations

1023 Medical Center Pkwy
Ste 401
Selma, AL 36701
Phone (334) 875-7173

1023 Medical Center Pkwy
Ste 305
Selma, AL 36701
Phone (334) 801-9952

203 Vaughan Memorial Dr
Selma, AL 36701
Phone (334) 375-8007

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19364/brand/1/csg/21/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/17793/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1104867837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367020570",
            "telephone_number": "334-375-8007",
            "fax_number": "334-877-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 VAUGHAN MEMORIAL DR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016950",
            "telephone_number": "334-375-8007",
            "fax_number": "334-526-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "TAMARAH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-049707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630902049",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630904049",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630900049",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-52699",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

Verify at the official NPI Registry.