Individual provider Active NPI

Cory J Mazour, MD

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1811903388
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22967 Issued in NE
Practice address
9116 Lamont St
Omaha, NE 68124-3822
Phone
(402) 210-1221
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22967 NE Primary

Addresses

Primary practice location

9116 Lamont St
Omaha, NE 68124-3822

Mailing address

9116 Lamont St
Omaha, NE 68124-3822
Phone (402) 210-1221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20120507000706 TX Practitioner - Family Practice 5193785137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Apr 23, 2012 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Apr 23, 2012 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

Organizations & group practices 4

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1811903388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9116 LAMONT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243822",
            "telephone_number": "402-210-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9116 LAMONT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243822",
            "telephone_number": "402-210-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZOUR",
        "first_name": "CORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.