Individual provider Active NPI

Elizabeth Jo Mason, M.D.

  • Child & Adolescent Psychiatry Physician
  • Greenville, SC
National Provider Identifier
1235367822
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
31921 Issued in SC
Practice address
200 Patewood Dr Ste A100
Greenville, SC 29615
Phone
(864) 454-5612
Fax
(864) 454-5121
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL31921 SC
Child & Adolescent Psychiatry Physician 2084P0804X 31921 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste A100
Greenville, SC 29615

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other practice location 1

11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-4605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922002040 SC Practitioner - Psychiatry 5991924029 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL31921SCMDPsychiatry Physician
31921SCMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Mar 27, 2017 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 1, 2018 Accepting new patients
Prisma Health Medical Group-Midlands Psychiatry CurrentSince Mar 27, 2017 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 1, 2018 Accepting new patients

Locations

11 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-4506

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3 Richland Medical Park Dr
Ste 510
Columbia, SC 29203
Phone (803) 296-2726

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Ste A100
Greenville, SC 29615
Phone (864) 454-5612

200 Patewood Dr
Ste A10
Greenville, SC 29615
Phone (864) 454-2222

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

Interoperability endpoints

  • Direct secure messaging: emason235353@direct.ghs.myhfn.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1235367822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE A100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-454-5612",
            "fax_number": "864-454-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Richland Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036863",
            "country_code": "US",
            "telephone_number": "803-434-4605",
            "fax_number": "803-434-1537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "ELIZABETH",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL31921",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "31921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.