Individual provider Active NPI

Glenn Mason, NP

  • Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1184074643
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R888556 Issued in MS
Practice address
670 Leigh Dr
Columbus, MS 39705-3014
Phone
(662) 328-1012
Fax
(662) 328-1507
NPI assigned
Jun 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R888556 MS Primary

Addresses

Primary practice location

670 Leigh Dr
Columbus, MS 39705-3014

Mailing address

670 Leigh Dr
Columbus, MS 39705-3014
Phone (662) 328-1012

Other practice location 1

17540 E Main St
Louisville, MS 39339-2772
Phone (662) 328-1012

Other practice location 2

4 Professional Plz
Starkville, MS 39759-1901
Phone (662) 328-1012

Other practice location 3

8613 MS Highway 12
Ackerman, MS 39735-8917
Phone (662) 328-1012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20160728001913 MS Practitioner - Nurse Practitioner 3971896986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Columbus Orthopaedic Clinic, P.a.Group PAC ID 5890751945, 52 clinicians

Practice addresses (Care Compare)

670 Leigh Dr
Columbus, MS 39705-3014
Phone (662) 328-1012

Hospital & facility affiliations

  • Mississippi Homecare of Eupora Home health agency, Eupora, MS, CCN 257122
  • BMH-Golden Triangle Hospital, Columbus, MS, CCN 250100
  • Baptist Memorial Hospital-Oktibbeha County Hospital, Starkville, MS, CCN 250050
  • Monroe Regional Hospital Hospital, Aberdeen, MS, CCN 251302
  • Noxubee General Critical Access Hosp Hospital, Macon, MS, CCN 251307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R888556MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oktibbeha County Hospital Current Accepting new patients
The Columbus Orthopaedic Clinic, P.a. CurrentSince Jan 13, 2025 Accepting new patients
The Columbus Orthopaedic Clinic, P.a. CurrentSince Jan 13, 2025 Accepting new patients
The Columbus Orthopaedic Clinic, P.a. Past Accepting new patients

Locations

8613 MS Highway 12
Ackerman, MS 39735
Phone (662) 285-4400

670 Leigh Dr
Columbus, MS 39705
Phone (662) 327-4540

4 Professional Plz
Starkville, MS 39759
Phone (662) 323-3684

Interoperability endpoints

  • Direct secure messaging: glennmason@och.allscriptsdirect.net

Organizations & group practices 4

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 5

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1184074643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012",
            "fax_number": "662-328-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012",
            "fax_number": "662-328-1507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17540 E Main St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "MS",
            "postal_code": "393392772",
            "country_code": "US",
            "telephone_number": "662-328-1012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Professional Plz",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397591901",
            "country_code": "US",
            "telephone_number": "662-328-1012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8613 MS Highway 12",
            "address_purpose": "LOCATION",
            "city": "Ackerman",
            "state": "MS",
            "postal_code": "397358917",
            "country_code": "US",
            "telephone_number": "662-328-1012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R888556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.