Masonboro Family Medicine, P.C.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

MASONBORO FAMILY MEDICINE, P.C.

Practice address

6419 Carolina Beach Road
Suite a
Wilmington, NC 28412-2788

Phone

(910) 790-3660

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Erin Carter

Title

Billing Office

Phone

(910) 790-3660

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1417018565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6419 CAROLINA BEACH ROAD",
            "address_2": "SUITE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122788",
            "telephone_number": "910-790-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6419 CAROLINA BEACH ROAD",
            "address_2": "SUITE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122788",
            "telephone_number": "910-790-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONBORO FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "BILLING OFFICE",
        "authorized_official_telephone_number": "910-790-3660",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051C3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18265",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015C3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "10892",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "61634",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87545",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910892",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8961634",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Mascarenas
• Anastasia Masle, MD
• Allison Owens Mason, MT-BC, CCLS
• David P Mason, MD
• John Morgan Mason, DO
• Masonboro Medical Group, PC
• Masonboro Urgent Care, PC
• Hannah Maliha Masoud, M.D.
• Marissa Massey, RBT
• Taylor Mast, DMD

• Preferred Provider Organization in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Preferred Provider Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.