Individual provider Active NPI

Carlyn Bailey Mason, APN-C

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1336237338
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP114411 Issued in TX
Practice address
2002 Lanark Ave
Dallas, TX 75203-4525
Phone
(214) 434-8590
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP114411 TX Primary

Addresses

Primary practice location

2002 Lanark Ave
Dallas, TX 75203-4525

Mailing address

2002 Lanark Ave
Dallas, TX 75203-4525
Phone (214) 434-8590

Other identifiers 1

IdentifierTypeStateIssuer
177846601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000407 TX Practitioner - Nurse Practitioner 1052332780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP114411TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Apr 1, 2024 Accepting new patients
Vpa of Texas PLLC CurrentSince Apr 1, 2024 Accepting new patients
Health Now Better Now PastSince Mar 24, 2024 Accepting new patients
Harold Wagner DO PA Geriatric Medicine Past Accepting new patients
Ingenios Health Co. Past Accepting new patients
Indelible Health & Wellness LLC Past Accepting new patients

Locations

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Interoperability endpoints

  • Direct secure messaging: carlyn.bailey.mason.1@29558.direct.athenahealth.com

Organizations & group practices 6

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1336237338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 LANARK AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752034525",
            "telephone_number": "214-434-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 LANARK AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752034525",
            "telephone_number": "214-434-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY MASON",
        "first_name": "CARLYN",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP114411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177846601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.