Individual provider Active NPI

Jan Mason

  • Physical Therapy Assistant
  • Lakewood Ranch, FL
National Provider Identifier
1184053852
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
6416 Golden Eye GLN
Lakewood Ranch, FL 34202-5834
Phone
(941) 993-6443
NPI assigned
Nov 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

6416 Golden Eye GLN
Lakewood Ranch, FL 34202-5834

Mailing address

6416 Golden Eye GLN
Lakewood Ranch, FL 34202-5834
Phone (941) 993-6443

Other identifiers 1

IdentifierTypeStateIssuer
M250433772040OtherFLLIC NUMBER

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

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1184053852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 GOLDEN EYE GLN",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025834",
            "telephone_number": "941-993-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6416 GOLDEN EYE GLN",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025834",
            "telephone_number": "941-993-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "JAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC NUMBER",
            "identifier": "M250433772040",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.