Mason Wiebe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1200 E Elizabeth St
Fort Collins, CO 80524-4007

Phone

(970) 267-9510

NPI assigned

Jun 28, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: masonwiebe@yc.allscriptsdirect.net

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.

• Fort Collins Youth Clinic

  • Pediatrics Physician
  • Fort Collins, CO
  • NPI 1336292622
  NPD
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  NPD (past)

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1316398597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 E FLORIDA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223615",
            "telephone_number": "970-692-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E ELIZABETH ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244007",
            "telephone_number": "970-267-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBE",
        "first_name": "MASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa Hays Wicklund, PH.D.
• Erika H Wicks, P.A.-C
• Rowan Wicks, PMHNP-BC
• Eric Walton Wideman
• Barbara Widom, M.D.
• Kelly Wiechert, RN
• Robin Wiedeman, LPC
• Abigail Lois Wiggins, LMT
• Lara Kathleen Wiginton-McCormick, CNM
• Roy Montgomery Wilburn, D.C.

• Physician Assistant in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.