Individual provider Active NPI

Shawn Mason, PHD

  • Clinical Psychologist
  • Largo, FL
National Provider Identifier
1841466950
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12451 Issued in FL
Practice address
11580 Oakhurst Rd
St. a-1
Largo, FL 33774
Phone
(727) 248-2438
Fax
(410) 550-8161
NPI assigned
May 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04693 MD
Clinical Psychologist 103TC0700X PY12451 FL Primary

Addresses

Primary practice location

11580 Oakhurst Rd
St. a-1
Largo, FL 33774

Mailing address

11580 Oakhurst Rd
St. a-1
Largo, FL 33774
Phone (727) 248-2438

Other practice location 1

5510 N Hesperides St
Tampa, FL 33614-5414
Phone (813) 467-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250128002255 FL Practitioner - Clinical Psychologist 9537698147 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY12451FLMDClinical Psychologist
04693MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Behavioral Sciences Tampa LLC CurrentSince Jan 27, 2025 Accepting new patients

Locations

4201 31st St S
St Petersburg, FL 33712
Phone (727) 867-1104

5510 N Hesperides St
Tampa, FL 33614
Phone (727) 418-2567

Organizations & group practices 1

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": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1841466950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11580 OAKHURST RD",
            "address_2": "ST. A-1",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33774",
            "telephone_number": "727-248-2438",
            "fax_number": "410-550-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11580 OAKHURST RD",
            "address_2": "ST. A-1",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33774",
            "telephone_number": "727-248-2438",
            "fax_number": "410-550-8161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5510 N Hesperides St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336145414",
            "country_code": "US",
            "telephone_number": "813-467-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "SHAWN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04693",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.