Active NPI
Walter Lawrence Mason, M.D.
- Specialist
- Greeneville, TN
National Provider Identifier
1942391636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD0000003164
- Practice address
- 1410 Tusculum Blvd
Siuite 1700
Greeneville, TN 37745-4286 - Phone
- (423) 787-7100
- Fax
- (423) 787-7109
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD0000003164 | TN | Primary |
Addresses
Primary practice location
1410 Tusculum Blvd
Siuite 1700
Greeneville, TN 37745-4286
Mailing address
1410 Tusculum Blvd
Siuite 1700
Greeneville, TN 37745-4286
Phone (423) 787-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3116878 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000003164 | TN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260748800000",
"number": "1942391636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 TUSCULUM BLVD",
"address_2": "SIUITE 1700",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377454286",
"telephone_number": "423-787-7100",
"fax_number": "423-787-7109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 TUSCULUM BLVD",
"address_2": "SIUITE 1700",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377454286",
"telephone_number": "423-787-7100",
"fax_number": "423-787-7109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "WALTER",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2009-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "MD0000003164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3116878",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeneville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.