Active NPI
Annette Marie Mason, PT
- Physical Therapist
- Charles Town, WV
National Provider Identifier
1952571655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT000689
- Practice address
- 110 Mordington Avenue
Jefferson County Board of Education
Charles Town, WV 25414 - Phone
- (304) 725-9741
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT000689 | WV | Primary |
Addresses
Primary practice location
110 Mordington Avenue
Jefferson County Board of Education
Charles Town, WV 25414
Mailing address
56 Longfield Lane
Shenandoah Junction, WV 25442
Phone (304) 876-3572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0156312000 | Medicaid | WV |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT000689 | WV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson County Board of Education | Past | Accepting new patients | |
| Jefferson County Schools | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Charles Town, WV
- NPI 1750550570
-
- Local Education Agency (LEA)
- Charles Town, WV
- NPI 1639367402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1952571655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 LONGFIELD LANE",
"city": "SHENANDOAH JUNCTION",
"state": "WV",
"postal_code": "25442",
"telephone_number": "304-876-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MORDINGTON AVENUE",
"address_2": "JEFFERSON COUNTY BOARD OF EDUCATION",
"city": "CHARLES TOWN",
"state": "WV",
"postal_code": "25414",
"telephone_number": "304-725-9741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "ANNETTE",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "PT000689",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0156312000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charles Town, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.