Individual provider Active NPI

William Howard Mason III

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1497347710
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
3085 S Jones Blvd Ste D
Las Vegas, NV 89146-6767
Phone
(702) 888-0036
NPI assigned
Feb 8, 2021
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

3085 S Jones Blvd Ste D
Las Vegas, NV 89146-6767

Mailing address

6205 Peggotty Ave
Las Vegas, NV 89130-1375

Other identifiers 1

IdentifierTypeStateIssuer
2000623550MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL grayson.7907@gmail.com

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Mental Health Support Services, Inc. Single Specialty CurrentSince Feb 14, 2021 Accepting new patients

Locations

3085 S Jones Blvd
Ste D
Las Vegas, NV 89146
Phone (702) 888-0036

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1497347710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6205 PEGGOTTY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 S JONES BLVD STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466767",
            "telephone_number": "702-888-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "WILLIAM",
        "middle_name": "HOWARD",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000623550",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "grayson.7907@gmail.com",
            "affiliation": "N",
            "address_1": "3085 S Jones Blvd Ste B",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891466767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.