Active NPI
Jan Machelle McNeil-Glassford, MD
- Pediatrics Physician
- New Kent, VA
National Provider Identifier
1063733962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101270321
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170113001299 | WV | Practitioner - Pediatric Medicine | 1557643236 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101270321 | VA | MD | Pediatrics Physician |
| 25035 | WV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.