Active NPI
Old Mission Wound Care North Carolina, PLLC
- Specialist
- Traverse City, MI
National Provider Identifier
1194565150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- OLD MISSION WOUND CARE NORTH CAROLINA, PLLC
- Practice address
- 1989 Kroupa Rd
Traverse City, MI 49686-9759 - Phone
- (231) 260-4622
- NPI assigned
- May 28, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christopher P Mason, DO
- Title
- Owner
- Phone
- (231) 260-4622
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
1989 Kroupa Rd
Traverse City, MI 49686-9759
Mailing address
225 Matlage Way Unit 31
Sugar Land, TX 77487-0807
Phone (231) 260-4622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241025001557 | NC | Part B Supplier - Clinic/Group Practice | 0840723102 |
Receives reassigned benefits from 6 practitioners Practice locations: Raleigh, NC |
National Provider Directory
National Provider DirectoryLocations
414 Fayetteville St
Raleigh, NC 27601
Phone (910) 627-2410
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716854400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1723766400000",
"number": "1194565150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 MATLAGE WAY UNIT 31",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774870807",
"telephone_number": "231-260-4622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1989 KROUPA RD",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496869759",
"telephone_number": "231-260-4622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OLD MISSION WOUND CARE NORTH CAROLINA, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-28",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A",
"authorized_official_last_name": "MASON",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "231-260-4622",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
- Old Mission Wound Care Maryland LLC
- Old Mission Wound Care Michigan PLLC
- Old Mission Wound Care Minnesota PLLC
- Old Mission Wound Care Missouri LLC
- Old Mission Wound Care New Mexico LLC
- Old Mission Wound Care Ohio LLC
- Old Mission Wound Care Pennsylvania PLLC
- Old Mission Wound Care South Carolina LLC
- Old Mission Wound Care Tennessee PLLC
- Old Mission Wound Care Texas PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.