Individual provider Active NPI

Jan Machelle McNeil-Glassford, MD

  • Pediatrics Physician
  • New Kent, VA
National Provider Identifier
1063733962
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101270321 Issued in VA
Practice address
9407 Cumberland Rd
New Kent, VA 23124-2029
Phone
(804) 966-2242
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25035 WV
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 0101270321 VA Primary

Addresses

Primary practice location

9407 Cumberland Rd
New Kent, VA 23124-2029

Mailing address

9407 Cumberland Rd
New Kent, VA 23124-2029
Phone (804) 966-2242

Other practice location 1

1247 Suncrest Town Centre Dr
Morgantown, WV 26505-1876
Phone (304) 599-8000

Other practice location 2

1 Medical Center Drive
Morgantown, WV 26506
Phone (304) 598-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170113001299 WV Practitioner - Pediatric Medicine 1557643236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101270321VAMDPediatrics Physician
25035WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Hospital LLC Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1063733962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 CUMBERLAND RD",
            "city": "NEW KENT",
            "state": "VA",
            "postal_code": "231242029",
            "telephone_number": "804-966-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9407 CUMBERLAND RD",
            "city": "NEW KENT",
            "state": "VA",
            "postal_code": "231242029",
            "telephone_number": "804-966-2242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1247 Suncrest Town Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265051876",
            "country_code": "US",
            "telephone_number": "304-599-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Drive",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "26506",
            "country_code": "US",
            "telephone_number": "304-598-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNEIL-GLASSFORD",
        "first_name": "JAN",
        "middle_name": "MACHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "25035",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101270321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Kent, VA

Sources for this page

Verify at the official NPI Registry.