NPIMap

Organization Active NPI

Mike Mason Chiropractic PLLC

  • Chiropractor
  • Bridgeport, WV
National Provider Identifier
1255388971
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MIKE MASON CHIROPRACTIC PLLC
Practice address
529 E. Main St
Bridgeport, WV 26330
Phone
(304) 842-4202
Fax
(304) 842-6480
NPI assigned
May 28, 2006
Last updated
Jan 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Dr. Michael W. Mason, D.CNPI 1891732962
Title
Owner
Phone
(304) 842-4202

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)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

529 E. Main St
Bridgeport, WV 26330

Mailing address

529 E. Main St
Bridgeport, WV 26330
Phone (304) 842-4202

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidWV
001713619OtherWVMTN STATE BCBS PAY-TO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060601000111 WV Part B Supplier - Clinic/Group Practice 7517978760 Receives reassigned benefits from 12 practitioners
Practice locations: Bridgeport, WV

National Provider Directory

National Provider Directory

Locations

529 E Main St
Bridgeport, WV 26330
Phone (304) 842-4202

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1255388971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 E. MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-842-4202",
            "fax_number": "304-842-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 E. MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-842-4202",
            "fax_number": "304-842-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKE MASON CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-842-4202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MTN STATE BCBS PAY-TO",
            "identifier": "001713619",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.

Verify at the official NPI Registry.