=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336923887
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMIE LYNN MASON APRN, CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2023
-----------------------------------------------------
Last Update Date | 02/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3535 PENTAGON BLVD STE 220
-----------------------------------------------------
City | BEAVERCREEK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45431-1705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-429-7350
-----------------------------------------------------
Fax | 937-431-2623
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9500 EUCLID AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44195-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-502-4194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | CNM07828
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | APRN.CNM.0019555
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------