Individual provider Active NPI

Nicole M Gleussner, CNM

  • Midwife
  • Poland, OH
National Provider Identifier
1073227369
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
APRN.CNM.0019552 Issued in OH
Practice address
7067 Tiffany Blvd Ste 220
Poland, OH 44514-1981
Phone
(330) 758-2041
Fax
(330) 758-2042
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X APRN.CNM.0019552 OH Primary

Addresses

Primary practice location

7067 Tiffany Blvd Ste 220
Poland, OH 44514-1981

Mailing address

PO Box 14577
Poland, OH 44514-7577
Phone (330) 758-2041

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL obgyn2041@Yahoo.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125001157 OH Practitioner - Certified Nurse Midwife (CNM) 9739550054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Cincinnati College of Medicine and Surgery, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Babitha Nalluri MD LTDGroup PAC ID 8628041142, 6 clinicians

Practice addresses (Care Compare)

7067 Tiffany Blvd
Suite 220
Poland, OH 44514-1981
Phone (330) 758-2041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Babitha Nalluri MD LTD CurrentSince Jan 12, 2023 Accepting new patients
Mercy Health Youngstown LLC PastSince Jan 12, 2023 Accepting new patients

Locations

7067 Tiffany Blvd
Ste 220
Youngstown, OH 44514
Phone (330) 758-2041

7067 Tiffany Blvd
Youngstown, OH 44514
Phone (330) 726-7411

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.

NPI Registry JSON

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1073227369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14577",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445147577",
            "telephone_number": "330-758-2041",
            "fax_number": "330-758-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7067 TIFFANY BLVD STE 220",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445141981",
            "telephone_number": "330-758-2041",
            "fax_number": "330-758-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEUSSNER",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OH",
            "license": "APRN.CNM.0019552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "obgyn2041@Yahoo.com",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7067 Tiffany Blvd Ste 220",
            "city": "Poland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445141981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.