Individual provider Active NPI

Mary Richelle Mason, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1962249680
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1168660 Issued in TX
Practice address
8200 Nashville Ave
Lubbock, TX 79423-1906
Phone
(214) 734-1654
NPI assigned
Jul 10, 2024
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1168660 TX Primary

Addresses

Primary practice location

8200 Nashville Ave
Lubbock, TX 79423-1906

Mailing address

8200 Nashville Ave # 202
Lubbock, TX 79423-1906
Phone (806) 687-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812001802 TX Practitioner - Nurse Practitioner 8426596222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allan J McCorkle MdpaGroup PAC ID 9537233978, 6 clinicians

Practice addresses (Care Compare)

9 Medical Dr
Amarillo, TX 79106-4137
Phone (806) 352-2731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allan J. McCorkle, M.D.,P.a. CurrentSince Jul 18, 2024 Accepting new patients

Locations

3 Medical Dr
Ste A
Amarillo, TX 79106
Phone (806) 355-1313

7021 Kewanee Ave
Unit 6104
Lubbock, TX 79424
Phone (806) 355-1313

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, 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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1962249680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 NASHVILLE AVE # 202",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231906",
            "telephone_number": "806-687-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231906",
            "telephone_number": "214-734-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "MARY",
        "middle_name": "RICHELLE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1168660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.