Individual provider Active NPI

Gary R Glisson, R PH

  • Pharmacist
  • Nashville, NC
National Provider Identifier
1033111968
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7023 Issued in NC
Practice address
117 W Church St
Nashville, NC 27856-1327
Phone
(252) 459-2135
Fax
(252) 459-9300
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7023 NC Primary
Durable Medical Equipment & Medical Supplies 332B00000X 20733 NC
Prosthetic/Orthotic Supplier 335E00000X 20733 NC
Podiatric Assistant 211D00000X 20733 NC

Addresses

Primary practice location

117 W Church St
Nashville, NC 27856-1327

Mailing address

PO Box 400
Nashville, NC 27856-0400
Phone (252) 459-2135

Other identifiers 2

IdentifierTypeStateIssuer
20733OtherNCBCP-BOARD OF CERTIFICATION IN PEDORTHICS
7795227MedicaidNC

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
7023NCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nashville Wellness Clinic & Medi-Spa PA Past Accepting new patients
Ward Drug Company of Nashville Inc Durable Medical Equipment & Medical Supplies 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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1033111968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278560400",
            "telephone_number": "252-459-2135",
            "fax_number": "252-459-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W CHURCH ST",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278561327",
            "telephone_number": "252-459-2135",
            "fax_number": "252-459-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLISSON",
        "first_name": "GARY",
        "middle_name": "R",
        "credential": "R PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "7023",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "20733",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "20733",
            "primary": false
        },
        {
            "code": "211D00000X",
            "taxonomy_group": "",
            "desc": "Assistant, Podiatric",
            "state": "NC",
            "license": "20733",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCP-BOARD OF CERTIFICATION IN PEDORTHICS",
            "identifier": "20733",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7795227",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.