Stephen H. Glassley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01018040A Issued in IN

Practice address

2710 Lake Ave
Fort Wayne, IN 46805-5412

Phone

(260) 373-8070

Fax

(260) 373-8071

NPI assigned

Dec 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Chiropractic Resource Center

  • Chiropractor
  • New Haven, IN
  • NPI 1124120373
  NPD (past)
• Parkview Hospital, Inc.

  • Trauma Surgery Physician
  • Fort Wayne, IN
  • NPI 1669576997
  NPD (past)

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1063497444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 E DUPONT RD",
            "address_2": "SUITE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-373-9700",
            "fax_number": "260-373-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055412",
            "telephone_number": "260-373-8070",
            "fax_number": "260-373-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSLEY",
        "first_name": "STEPHEN",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01018040A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000111940",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "00001076337 05",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "1335",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080130064",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4047058",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048970",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason P Glassley, D.D.S., M.S.D.
• Jeffrey L Glassley, DDS
• Michael Robert Glassley, D.D.S.
• Sara Glassley, NP
• Scott M Glassley, DDS
• Altermease Gleason, LMT, MMP
• Matilde Gleason
• Amber Glessner
• Angela Glick, LMHC
• Global Management Group Inc

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.