Fortenise A Mason, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

901481 Issued in MS

Practice address

514H E Woodrow Wilson Ave
Jackson, MS 39216-4538

Phone

(601) 713-3900

Fax

(601) 713-3970

NPI assigned

Jan 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Fortenise A Garrett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: fortenise.mason.1@31723.direct.athenahealth.com

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.

• Peace Children's Clinic

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1891975603
  NPD (past)

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1174068704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 EAGLES NEST DR",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729328",
            "telephone_number": "601-421-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514H E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-713-3900",
            "fax_number": "601-713-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "FORTENISE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FORTENISE",
            "last_name": "GARRETT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adriana Stephania Martini, MD
• Catina Marucci, MD
• Megan Mascaro
• Anna Reagan Mask
• Chawla Latoya Mason, M.D.
• Jenee Michelle Mason, APMHNP, FNP
• John Mark Andrew Mason, MD
• Sarah Joanna Mason, PA-C
• Whitney Mason
• Massage Revolution

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.