Active NPI
Gary R Glisson, R PH
- Pharmacist
- Nashville, NC
National Provider Identifier
1033111968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7023
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20733 | Other | NC | BCP-BOARD OF CERTIFICATION IN PEDORTHICS |
| 7795227 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7023 | NC | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community/Retail Pharmacy
- Nashville, NC
- NPI 1134234172
Durable Medical Equipment & Medical Supplies
-
- Family Medicine Physician
- Nashville, NC
- NPI 1508293192
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.