Active NPI
Glenda Datsko, CPM, LM
- Midwife
- Lutz, FL
National Provider Identifier
1104187871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 380
- Practice address
- 17499 Hanna Rd
Lutz, FL 33549-5669 - Phone
- (727) 642-6586
- NPI assigned
- May 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Lactation Consultant (Non-RN) | 174N00000X | FL | ||
| Doula | 374J00000X | FL | ||
| Midwife | 176B00000X | 380 | FL | Primary |
Addresses
Primary practice location
17499 Hanna Rd
Lutz, FL 33549-5669
Mailing address
17499 Hanna Rd
Lutz, FL 33549-5669
Phone (727) 642-6586
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 380 | FL | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684972800000",
"number": "1104187871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17499 HANNA RD",
"city": "LUTZ",
"state": "FL",
"postal_code": "335495669",
"telephone_number": "727-642-6586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17499 HANNA RD",
"city": "LUTZ",
"state": "FL",
"postal_code": "335495669",
"telephone_number": "727-642-6586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATSKO",
"first_name": "GLENDA",
"credential": "CPM, LM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-30",
"last_updated": "2023-05-25",
"certification_date": "2023-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "FL",
"license": "380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.