Active NPI
Collier Branan Gladin Jr., M.D.
- Family Medicine Physician
- Macon, GA
National Provider Identifier
1063527430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 030609
- Practice address
- 140 N Crest Blvd
Macon, GA 31210-1845 - Phone
- (478) 757-8335
- Fax
- (478) 757-8353
- NPI assigned
- Aug 19, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 030609 | GA | Primary |
Addresses
Primary practice location
140 N Crest Blvd
Macon, GA 31210-1845
Mailing address
140 N Crest Blvd
Macon, GA 31210-1845
Phone (478) 757-8335
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00383446D | Medicaid | GA | |
| 582393019 | Other | GA | FEDERAL TAX ID |
| 030609 | Other | GA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Mercer University School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
140 N Crest Blvd
Macon, GA 31210-1845
140 Northcrest Blvd
Macon, GA 31210-1845
Hospital & facility affiliations
- Amedisys Home Health of Macon
- Atrium Health Navicent the Medical Center
- Coliseum Medical Centers, LLC, Dba
- Piedmont Macon North Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 19 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collier B. Gladin, Jr., M.D., LLC | Family Medicine | Current | Accepting new patients |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
140 N Crest Blvd
Macon, GA 31210
Phone (478) 757-8335
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CJJEAA/Endpoint/CJJEAA
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.
-
dba Collier B Gladin Jr MD
- Family Medicine Physician
- Macon, GA
- NPI 1780992198
-
dba Memorial Hospital and Manor
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Amedisys Home Health of Macon
- Home Health Agency
- Macon, GA
- NPI 1356399018
-
dba Piedmont Macon Medical Center
- General Acute Care Hospital
- Macon, GA
- NPI 1598719643
-
dba Piedmont Macon North Hospital
- General Acute Care Hospital
- Macon, GA
- NPI 1811940976
-
dba Atrium Health Navicent The Medical Center
- General Acute Care Hospital
- Macon, GA
- NPI 1043270564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063527430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 N CREST BLVD",
"city": "MACON",
"state": "GA",
"postal_code": "312101845",
"telephone_number": "478-757-8335",
"fax_number": "478-757-8353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 N CREST BLVD",
"city": "MACON",
"state": "GA",
"postal_code": "312101845",
"telephone_number": "478-757-8335",
"fax_number": "478-757-8353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLADIN",
"first_name": "COLLIER",
"middle_name": "BRANAN",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "030609",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00383446D",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "582393019",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "030609",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.