Mark L Mason OD., LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

4574 Issued in OH

Legal business name

MARK L MASON OD., LLC

Practice address

907 Schneider St SE
North Canton, OH 44720-3774

Phone

(330) 499-1494

Fax

(330) 499-3744

NPI assigned

Nov 25, 2014

Organization subpart

No

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

Authorized official

Name

Kim J Wahl

Title

Clerical

Phone

(330) 499-1494

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark L. Mason, O.D.

  • Optometrist
  • North Canton, OH
  • NPI 1770699340
  Medicare reassignment NPD

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1508263120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 SCHNEIDER ST SE",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447203774",
            "telephone_number": "330-499-1494",
            "fax_number": "330-499-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 SCHNEIDER ST SE",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447203774",
            "telephone_number": "330-499-1494",
            "fax_number": "330-499-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK L MASON OD., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "WAHL",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CLERICAL",
        "authorized_official_telephone_number": "330-499-1494"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OH",
            "license": "4574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0997917",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Marchal, COTA/L
• Beth A Marcinkoski, MD
• Lori Ann Marietta, ACNS
• Melanie Marinelli, LPTA
• Joseph F. Marino, M.D.
• Cheryl M Markle, MD
• Carmen H Markley, L.P.T.
• Mitchell Lewis Leroy Markley, COTA/L
• Seth P Markwalter, PTA
• James A Marlowe, COTA/L

• Preferred Provider Organization in North Canton, OH
• Providers in North Canton, OH by specialty
• Preferred Provider Organization in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.