Individual provider Active NPI

Olga Mason, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1619348158
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
RN211605 Issued in GA
Practice address
2675 N Decatur Rd
Suite 512
Decatur, GA 30033-6131
Phone
(404) 508-5012
Fax
(404) 508-5560
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN211605 GA Primary

Addresses

Primary practice location

2675 N Decatur Rd
Suite 512
Decatur, GA 30033-6131

Mailing address

2675 N Decatur Rd
Ste 512
Decatur, GA 30033-6134
Phone (404) 508-5014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170301000952 GA Practitioner - Certified Nurse Midwife (CNM) 2264732940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 20, 2017 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 20, 2017 Accepting new patients
Dekalb Women'S Specialists 2 LLC Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Dekalb Women'S Specialists Past Accepting new patients
Dekalb Women'S Specialists Past Accepting new patients

Locations

4550 Cobb Parkway North NW
Ste 301
Acworth, GA 30101
Phone (678) 574-3135

1120 Wellstar Way
Ste 304
Holly Springs, GA 30114
Phone (678) 445-5941

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

699 Church St NE
Ste 500
Marietta, GA 30060
Phone (770) 424-7100

120 Stonebridge Pkwy
Ste 210
Woodstock, GA 30189
Phone (678) 445-5941

Interoperability endpoints

  • Direct secure messaging: omason134364@directwellstar.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1619348158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "STE 512",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336134",
            "telephone_number": "404-508-5014",
            "fax_number": "404-508-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "SUITE 512",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336131",
            "telephone_number": "404-508-5012",
            "fax_number": "404-508-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "OLGA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN211605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.