NPIMap

Individual provider Active NPI

Mason Clarke Harrison, F.N.P.

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1356355846
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200550153NP Issued in OR
Practice address
3144 State St
Medford, OR 97504-8450
Phone
(541) 226-9840
Fax
(541) 226-9846
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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 200550153NP OR Primary

Addresses

Primary practice location

3144 State St
Medford, OR 97504-8450

Mailing address

1833 Nebraska Ave
Grants Pass, OR 97527-5701
Phone (541) 226-9840

Other identifiers 3

IdentifierTypeStateIssuer
P01349583OtherORRAILROAD MEDICARE IND
DU9308OtherORRAILROAD MEDICARE GRP
026845MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060803000383 OR Practitioner - Nurse Practitioner 3375556640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3144 State St
Medford, OR 97504-8450
Phone (541) 226-9840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
River Rock Family Practice PC Family CurrentSince Nov 25, 2013 Accepting new patients
River Rock Family Practice PC Family CurrentSince Nov 25, 2013 Accepting new patients
Raymond a Millette Family Past Accepting new patients

Locations

1833 Nebraska Ave
Grants Pass, OR 97527
Phone (541) 226-9840

3144 State St
Medford, OR 97504
Phone (541) 772-9355

Interoperability endpoints

  • Direct secure messaging: mason.harrison.riverrockfamilypractice@jhie.net

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1356355846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275701",
            "telephone_number": "541-226-9840",
            "fax_number": "541-226-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-226-9840",
            "fax_number": "541-226-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MASON",
        "middle_name": "CLARKE",
        "name_prefix": "Mr.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200550153NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE IND",
            "identifier": "P01349583",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP",
            "identifier": "DU9308",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026845",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.