Individual provider Active NPI

Michael W Mason, D.C.

  • Chiropractor
  • Bridgeport, WV
National Provider Identifier
1891732962
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
777 Issued in WV
Practice address
529 E Main St
Bridgeport, WV 26330-1824
Phone
(304) 842-4202
Fax
(304) 842-6480
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 777 WV Primary

Addresses

Primary practice location

529 E Main St
Bridgeport, WV 26330-1824

Mailing address

529 E Main St
Bridgeport, WV 26330-1824
Phone (304) 842-4202

Other identifiers 2

IdentifierTypeStateIssuer
001713618OtherWVMTN. STATE BCBS RENDERING
PENDINGMedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060605000002 WV Practitioner - Chiropractic 9335150580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mike Mason Chiropractic PLLCGroup PAC ID 7517978760, 5 clinicians

Practice addresses (Care Compare)

529 E Main St
Bridgeport, WV 26330-1824
Phone (304) 842-4202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
777WVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mike Mason Chiropractic PLLC Chiropractor CurrentSince Mar 1, 2006 Accepting new patients
Chiropractic Care Center PLLC Chiropractor PastSince Sep 1, 2017 Accepting new patients

Locations

109 Doctors Dr
#B
Bridgeport, WV 26330
Phone (304) 842-4202

529 E Main St
Bridgeport, WV 26330
Phone (304) 376-9792

Organizations & group practices 2

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1891732962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301824",
            "telephone_number": "304-842-4202",
            "fax_number": "304-842-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301824",
            "telephone_number": "304-842-4202",
            "fax_number": "304-842-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MTN. STATE BCBS RENDERING",
            "identifier": "001713618",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.