Active NPI
Mason Reese Mathis III, PHARMD
- Pharmacist
- Summerville, SC
National Provider Identifier
1265793632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13687
- Practice address
- 1584 Central Ave
Summerville, SC 29483-5528 - Phone
- (843) 871-9289
- Fax
- (843) 871-2925
- NPI assigned
- Jun 1, 2012
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13687 | SC | Primary |
Addresses
Primary practice location
1584 Central Ave
Summerville, SC 29483-5528
Mailing address
1584 Central Ave
Summerville, SC 29483-5528
Phone (843) 871-9289
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13687 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1584 Central Ave
Summerville, SC 29483
Phone (843) 871-9289
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": "1338508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1265793632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1584 CENTRAL AVE",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294835528",
"telephone_number": "843-871-9289",
"fax_number": "843-871-2925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1584 CENTRAL AVE",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294835528",
"telephone_number": "843-871-9289",
"fax_number": "843-871-2925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "MASON",
"middle_name": "REESE",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-01",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "13687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.