Active NPI
Mitchell T. Massie, M.D.
- Surgery Physician
- Tallahassee, FL
National Provider Identifier
1285616367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME0073308
- Practice address
- 2631 Centennial Blvd
Suite 100
Tallahassee, FL 32308-0588 - Phone
- (850) 877-8539
- Fax
- (850) 877-6674
- NPI assigned
- Nov 15, 2005
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME0073308 | FL | Primary |
Addresses
Primary practice location
2631 Centennial Blvd
Suite 100
Tallahassee, FL 32308-0588
Mailing address
2631 Centennial Blvd
Suite 100
Tallahassee, FL 32308-0588
Phone (850) 877-8539
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276918200 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME0073308 | FL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490918400000",
"number": "1285616367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2631 CENTENNIAL BLVD",
"address_2": "SUITE 100",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323080588",
"telephone_number": "850-877-8539",
"fax_number": "850-877-6674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2631 CENTENNIAL BLVD",
"address_2": "SUITE 100",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323080588",
"telephone_number": "850-877-8539",
"fax_number": "850-877-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSIE",
"first_name": "MITCHELL",
"middle_name": "T.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2017-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME0073308",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276918200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.