Omodele Julie Masha, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2009-01717 Issued in NC

Practice address

518 Brookdale Dr
Statesville, NC 28677-4108

Phone

(704) 872-9595

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment NPD
• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215
  Medicare reassignment NPD
• Henderson County Hospital Corporation

  • Multi-Specialty Clinic/Center
  • Hendersonville, NC
  • NPI 1447444559

  Family Medicine

  Medicare reassignment NPD
• Apogee Medical Group North Carolina

  • Hospitalist Physician
  • Scottsdale, AZ
  • NPI 1043518228

  NC

  Medicare reassignment NPD
• Vohra Wound Physicians of Ny, PLLC

  • Family Medicine Physician
  • New York, NY
  • NPI 1447527320

  NC

  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Caromont Medical Group, Inc.

  • Hospitalist Physician
  • Gastonia, NC
  • NPI 1912188939
  NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD
• Henderson County Hospital Corporation

  • Community/Retail Pharmacy
  • Hendersonville, NC
  • NPI 1013694165
  NPD
• Cogent Healthcare of North Carolina, PC

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1548207483

  Family Medicine

  NPD (past)
• Columbus Regional Health Network

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1518263268
  NPD (past)
• Peach Physician Services, PC

  • Hospitalist Physician
  • Byron, GA
  • NPI 1235821752
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1528164324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-0567",
            "fax_number": "704-874-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774108",
            "telephone_number": "704-872-9595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 SW 160th Ave",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330276308",
            "country_code": "US",
            "telephone_number": "877-866-7123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 SW 160th Ave",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330276308",
            "country_code": "US",
            "telephone_number": "877-866-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASHA",
        "first_name": "OMODELE",
        "middle_name": "JULIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-01717",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2009-01717",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-01717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09430542",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCNC",
            "identifier": "154VV",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1051675",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1004",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528164324",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda K Martin, LCSW MSW
• Gaitrice Martin, MSN, APRN, FNP-BC
• Ana Beatriz Martinez Ruiz, SURGICAL ASSISTANT-C
• Natalie Patricia Martinez-Jones, DPM
• Brenda Arlene Mash
• Lisa Key Mathis, NP
• Kimberly Ruth Mattingly-Cloer
• Whitney Lea Mattox, SLP-CCC
• Dawn Mauney
• Wayne Mavellia II, CRNA

• Pediatrics Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.