Individual provider Active NPI

Kelli S. Mason, DC

  • Chiropractor
  • Montrose, CO
National Provider Identifier
1205828845
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0008024 Issued in CO
Practice address
1541 Ogden Rd
Montrose, CO 81401-5683
Phone
(970) 252-0378
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1028 NE
Chiropractor 111N00000X 0008024 CO Primary
Chiropractor 111N00000X 2438 SC

Addresses

Primary practice location

1541 Ogden Rd
Montrose, CO 81401-5683

Mailing address

1807 4TH Corso
Suite 4
Nebraska City, NE 68410-2679
Phone (402) 874-9044

Other practice location 1

1807 4th Corso
Suite 4
Nebraska City, NE 68410-2679
Phone (402) 874-9044

Other identifiers 1

IdentifierTypeStateIssuer
8404OtherSCGROUP PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816001790 CO Practitioner - Chiropractic 4981518354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Atlas Chiropractic Montrose LLCGroup PAC ID 8123355989, 2 clinicians

Practice addresses (Care Compare)

1541 Ogden Rd
Montrose, CO 81401-5683
Phone (970) 252-0378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1028NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Clinic of Chiropractic LLC Chiropractor CurrentSince Aug 1, 2019 Accepting new patients
Atlas Chiropractic Montrose LLC Chiropractor CurrentSince Aug 1, 2019 Accepting new patients
The Wellness Place Chiropractor PastSince Feb 1, 2006 Accepting new patients

Locations

1541 Ogden Rd
Montrose, CO 81401
Phone (970) 252-0378

1807 4th Corso
Ste 4
Nebraska City, NE 68410
Phone (402) 874-9044

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1205828845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 4TH CORSO",
            "address_2": "SUITE 4",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684102679",
            "telephone_number": "402-874-9044",
            "fax_number": "844-270-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 OGDEN RD",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015683",
            "telephone_number": "970-252-0378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1807 4th Corso",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Nebraska City",
            "state": "NE",
            "postal_code": "684102679",
            "country_code": "US",
            "telephone_number": "402-874-9044",
            "fax_number": "844-270-5928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "KELLI",
        "middle_name": "S.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1028",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "0008024",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PIN",
            "identifier": "8404",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.