Lacy Elizabeth Mason, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013023 Issued in GA

Practice address

3888 Lavista Rd
Tucker, GA 30084-5142

Phone

(770) 938-5740

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1730737677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 JOHN WESLEY DOBBS AVE NE UNIT 808",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303125332",
            "telephone_number": "407-687-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3888 LAVISTA RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845142",
            "telephone_number": "770-938-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "LACY",
        "middle_name": "ELIZABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "endpointDescription": "na",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "na",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "na",
            "address_1": "3888 Lavista Rd",
            "city": "Tucker",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300845142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Tucker, GA
• Providers in Tucker, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.