Neil S Gladstone, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

016917 Issued in GA

Practice address

81 Upper Riverdale Rd
Suite 210
Riverdale, GA 30274-2627

Phone

(770) 996-1200

Fax

(770) 907-7492

NPI assigned

Oct 25, 2006

Last updated

Sep 5, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Innovative Health and Wellness LLC

  • Internal Medicine Physician
  • Woodstock, GA
  • NPI 1760796601
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1073697801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 962380",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302966921",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 UPPER RIVERDALE RD",
            "address_2": "SUITE 210",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742627",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSTONE",
        "first_name": "NEIL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "016917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113759B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Noshi Ghattas, MD
• Scott Alexander Gibson, LPN
• John Harold Giesler, M.D.
• Kenneth S Gimbel, MD
• Unknown Girish, M.D
• James E Gleason Jr., MD
• Glenn S Shear MDPC
• Global Care Centers, Inc
• Global Care Pharmacy Inc.
• Global Healing Creative Arts Therapy Studio

• Gynecology Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.