Individual provider Active NPI

Marisa Gladen, RN BSN

  • Case Management Registered Nurse
  • Arlington, TX
National Provider Identifier
1003206152
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
697482 Issued in TX
Practice address
3330 Matlock Rd Ste 207
Arlington, TX 76015-2917
Phone
(903) 647-4512
NPI assigned
Jan 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 697482 TX Primary

Addresses

Primary practice location

3330 Matlock Rd Ste 207
Arlington, TX 76015-2917

Mailing address

2717 Shadow Wood Dr
Arlington, TX 76006-2727
Phone (903) 647-4512

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
697482TXMDCase Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Selective Medical Staffing of Texas LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1003206152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 SHADOW WOOD DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760062727",
            "telephone_number": "903-647-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MATLOCK RD STE 207",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152917",
            "telephone_number": "903-647-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADEN",
        "first_name": "MARISA",
        "credential": "RN BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "697482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.