Organization Active NPI

Gladstone Primary Care PC

  • Family Medicine Physician
  • Hartselle, AL
National Provider Identifier
1134825003
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GLADSTONE PRIMARY CARE PC
Practice address
301 Pine St NW Ste a
Hartselle, AL 35640-2339
Phone
(256) 773-6017
Fax
(256) 773-7834
NPI assigned
Feb 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Juliana Clark, DNPNPI 1538587613
Title
Co-Owner
Phone
(256) 773-6017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

301 Pine St NW Ste a
Hartselle, AL 35640-2339

Mailing address

301 Pine St NW Ste a
Hartselle, AL 35640-2339
Phone (256) 773-6017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230608000784 AL Part B Supplier - Clinic/Group Practice 7315304201 Receives reassigned benefits from 3 practitioners
Practice locations: Hartselle, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2284730Gladstone Primary Care PC301 Pine Street Suite a, Hartselle, AL 35640Certificate of waiverJun 27, 2027

National Provider Directory

National Provider Directory

Locations

301 Pine St NW
Ste A
Hartselle, AL 35640
Phone (256) 773-5469

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1134825003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PINE ST NW STE A",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402339",
            "telephone_number": "256-773-6017",
            "fax_number": "256-773-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PINE ST NW STE A",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402339",
            "telephone_number": "256-773-6017",
            "fax_number": "256-773-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADSTONE PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JULIANA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "256-773-6017",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartselle, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.