Basic Information
| Provider Information | |||||||||
| NPI: | 1467428060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MASON | ||||||||
| FirstName: | NORA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MASON | ||||||||
| OtherFirstName: | CATE | ||||||||
| OtherMiddleName: | SHAPPLEY | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 195 W ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTHERN PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283875808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106922444 | ||||||||
| FaxNumber: | 9106923651 | ||||||||
| Practice Location | |||||||||
| Address1: | 195 W ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTHERN PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283875808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106922444 | ||||||||
| FaxNumber: | 9106923651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2006 | ||||||||
| LastUpdateDate: | 05/22/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 9800958 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 8912127 | 05 | NC | MEDICAID |