NPIMap

Individual provider Active NPI

Mary J. Mason, MD

  • Family Medicine Physician
  • Little River, SC
National Provider Identifier
1275670457
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36373 Issued in SC
Practice address
3361 Hwy 9 East
Little River, SC 29566-6041
Phone
(843) 497-5929
Fax
(843) 399-0123
NPI assigned
Jan 30, 2007
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36373 SC Primary

Addresses

Primary practice location

3361 Hwy 9 East
Little River, SC 29566-6041

Mailing address

PO Box 3439
North Myrtle Beach, SC 29582-0439
Phone (843) 839-4447

Other identifiers 1

IdentifierTypeStateIssuer
363733MedicaidSC

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic-Springfield Communities Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Mercy Clinic Springfield Communities Family Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1275670457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295820439",
            "telephone_number": "843-839-4447",
            "fax_number": "843-399-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3361 HWY 9 EAST",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295666041",
            "telephone_number": "843-497-5929",
            "fax_number": "843-399-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "MARY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "36373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363733",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.

Verify at the official NPI Registry.