Individual provider Active NPI

Mason L McGee, DPT

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1871926360
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
08643 Issued in LA
Practice address
1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone
(318) 813-2970
Fax
(318) 813-2981
NPI assigned
Aug 20, 2013
Last updated
Aug 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 08643 LA Primary

Addresses

Primary practice location

1450 Claiborne Ave
Shreveport, LA 71103-4204

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 813-2962

Other identifiers 1

IdentifierTypeStateIssuer
1174173MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327000066 LA Practitioner - Physical Therapist in Private Practice 1850653148 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08643LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physical Therapy and Performance, LLC Physical Therapist CurrentSince Mar 5, 2018 Accepting new patients
Fultz Physical Therapy and Joint Rehab, LLC Physical Therapist CurrentSince Jan 2, 2019 Accepting new patients
Glory Rehab Services LLC Physical Therapist CurrentSince May 13, 2024 Accepting new patients

Locations

4600 Barksdale Blvd
Bossier City, LA 71112
Phone (318) 459-7693

460 Ashley Ridge Blvd
Ste 800
Shreveport, LA 71106
Phone (318) 868-6172

4955 N Market St
Shreveport, LA 71107
Phone (318) 240-4758

5795 N Market St
Ste 8
Shreveport, LA 71107
Phone (318) 489-4298

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1871926360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-813-2962",
            "fax_number": "318-813-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CLAIBORNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034204",
            "telephone_number": "318-813-2970",
            "fax_number": "318-813-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGEE",
        "first_name": "MASON",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174173",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.