TJ Four Family

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TJ FOUR FAMILY

Practice address

5205 2ND Ave
Kearney, NE 68847-2471

Phone

(308) 440-2983

NPI assigned

Oct 19, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Timothy S Mason, APRNNPI 1992298962

Title

Owner

Phone

(308) 440-2983

Specialties & licenses 1

Addresses

Other names 2

• Tim Mason Family Medicine Doing business as
• TJ Four Family LLC Other name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy S Mason, APRN

  • Nurse Practitioner
  • Lexington, NE
  • NPI 1992298962
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1154047389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 SUNNY LN",
            "city": "GIBBON",
            "state": "NE",
            "postal_code": "688406282",
            "telephone_number": "308-440-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 2ND AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472471",
            "telephone_number": "308-440-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TJ FOUR FAMILY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-440-2983",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tim Mason Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TJ Four Family LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Primary Care Clinic/Center in Kearney, NE
• Providers in Kearney, NE by specialty
• Primary Care Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.