Individual provider Active NPI

Constant Shubert Masere, M.D.

  • Family Medicine Physician
  • Henderson, NC
National Provider Identifier
1275723900
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2010-00429 Issued in NC
Practice address
100 W Parkview Dr
Henderson, NC 27536-5923
Phone
(252) 438-3549
Fax
(252) 438-2084
NPI assigned
Jul 30, 2007
Last updated
Aug 31, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116019782 VA
Family Medicine Physician 207Q00000X 2010-00429 NC Primary

Addresses

Primary practice location

100 W Parkview Dr
Henderson, NC 27536-5923

Mailing address

100 W Parkview Dr
Henderson, NC 27536-5923
Phone (252) 438-3549

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

State licenses

LicenseStateTypeSpecialty
2010-00429NCMDFamily Medicine Physician
0116019782VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Community Health Centers Past Accepting new patients
First Choice Community Health Centers Family Medicine Past Accepting new patients
First Choice Community Health Centers Family Medicine Past Accepting new patients
First Choice Community Health Centers 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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1275723900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W PARKVIEW DR",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365923",
            "telephone_number": "252-438-3549",
            "fax_number": "252-438-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W PARKVIEW DR",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365923",
            "telephone_number": "252-438-3549",
            "fax_number": "252-438-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASERE",
        "first_name": "CONSTANT",
        "middle_name": "SHUBERT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116019782",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2010-00429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.