NPIMap

Organization Active NPI

Glade Run Medical Associates, Inc.

Doing business as Adult Medicine Associates-Kitanning

  • Non-Pharmacy Dispensing Site
  • Kittanning, PA
National Provider Identifier
1033258694
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
OS016078 Issued in PA
Legal business name
GLADE RUN MEDICAL ASSOCIATES, INC.
Doing business as
Adult Medicine Associates-Kitanning
Practice address
300 Medical Arts BLDG
Suite 300
Kittanning, PA 16201-7129
Phone
(724) 545-1288
NPI assigned
Feb 6, 2007
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Authorized official

Name
Mr. Scott Peterson
Title
Cfo
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS016078 PA Primary

Addresses

Primary practice location

300 Medical Arts BLDG
Suite 300
Kittanning, PA 16201-7129

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701
Phone (858) 625-2990

Other names 1

  • Adult Medicine Associates-Kitanning Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glade Run Medical Associates7 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1033258694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL ARTS BLDG",
            "address_2": "SUITE 300",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017129",
            "telephone_number": "724-545-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-06",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "858-625-2990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS016078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult Medicine Associates-Kitanning",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.