Glen Allen Hidden, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22420 Issued in SC

Practice address

50 E Hospital St
Suite 4
Manning, SC 29102-3149

Phone

(803) 435-5250

Fax

(803) 435-5255

NPI assigned

Jul 22, 2006

Last updated

Oct 17, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  NPD
• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  Family Medicine

  NPD (past)
• Floyd Healthcare Management Inc

  dba Atrium Health Floyd Specialty Pharmacy

  • Specialty Pharmacy
  • Rome, GA
  • NPI 1548056468
  NPD (past)
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287273600000",
    "number": "1063433050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E HOSPITAL ST",
            "address_2": "SUITE 4",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023149",
            "telephone_number": "803-435-5250",
            "fax_number": "803-435-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E HOSPITAL ST",
            "address_2": "SUITE 4",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023149",
            "telephone_number": "803-435-5250",
            "fax_number": "803-435-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIDDEN",
        "first_name": "GLEN",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043063",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "22420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "872533996A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lashon M Hammett
• Hanan N Ali (Soutien Gorge & More)
• Have Faith Cares, LLC
• Lisa E Heichberger, MD
• Sarah Brooke Heitzman, RDN, LD
• Joye R Hilton
• Stephanie A Hite, PT
• Erica Jones Hodge, DPT
• Ashley Lynn Hodges, APRN
• Hopehealth Inc (HopeHealth Manning School Based Clinic)

• Family Medicine Physician in Manning, SC
• Providers in Manning, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2010; 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.