Active NPI
Mitchell Joseph Mason
- Physical Therapist
- Petersburg, WV
National Provider Identifier
1194495978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004446
- Practice address
- 117 Hospital Dr
Petersburg, WV 26847-9566 - Phone
- (304) 257-1026
- NPI assigned
- Sep 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004446 | WV | Primary |
Addresses
Primary practice location
117 Hospital Dr
Petersburg, WV 26847-9566
Mailing address
35 Pinoak LN
Parsons, WV 26287-8045
Phone (304) 704-9085
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004446 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1194495978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 PINOAK LN",
"city": "PARSONS",
"state": "WV",
"postal_code": "262878045",
"telephone_number": "304-704-9085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 HOSPITAL DR",
"city": "PETERSBURG",
"state": "WV",
"postal_code": "268479566",
"telephone_number": "304-257-1026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "MITCHELL",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-14",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "004446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.