Active NPI
Mason G Edmunds, OCPSA
- Prevention Professional
- Youngstown, OH
National Provider Identifier
1609489624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- OCPSA.161826
- Practice address
- 527 N Meridian Rd
Youngstown, OH 44509-1227 - Phone
- (330) 797-0070
- NPI assigned
- Aug 28, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | RA.162173 | OH | |
| Prevention Professional | 405300000X | OCPSA.161826 | OH | Primary |
Addresses
Primary practice location
527 N Meridian Rd
Youngstown, OH 44509-1227
Mailing address
527 N Meridian Rd
Youngstown, OH 44509-1227
Phone (330) 797-0070
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OCPSA.161826 | OH | MD | Prevention Professional |
| RA.162173 | OH | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1609489624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 N MERIDIAN RD",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445091227",
"telephone_number": "330-797-0070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 N MERIDIAN RD",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445091227",
"telephone_number": "330-797-0070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMUNDS",
"first_name": "MASON",
"middle_name": "G",
"credential": "OCPSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-28",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "RA.162173",
"primary": false
},
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "OCPSA.161826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.