Individual provider Active NPI

Michael Mason Jr.

  • Specialist
  • Tiffin, OH
National Provider Identifier
1710505045
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
76 Ashwood Dr
Tiffin, OH 44883-1908
Phone
(419) 448-9440
NPI assigned
Jul 13, 2020
Last updated
Jul 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

76 Ashwood Dr
Tiffin, OH 44883-1908

Mailing address

1925 Hayes Ave
Sandusky, OH 44870-4737
Phone (419) 557-5177

Other practice location 1

122 W Center St
Fostoria, OH 44830-2201
Phone (419) 435-0204

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

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1710505045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704737",
            "telephone_number": "419-557-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 ASHWOOD DR",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448831908",
            "telephone_number": "419-448-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 W Center St",
            "address_purpose": "LOCATION",
            "city": "Fostoria",
            "state": "OH",
            "postal_code": "448302201",
            "country_code": "US",
            "telephone_number": "419-435-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "MICHAEL",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.