Individual provider Active NPI

Natausha Glidwell

  • Diagnostic Ultrasound Physician
  • Odessa, TX
National Provider Identifier
1134847312
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
146670 Issued in TX
Practice address
850 Tower Dr Ste 111
Odessa, TX 79761-4252
Phone
(432) 888-4886
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 146670 TX Primary

Addresses

Primary practice location

850 Tower Dr Ste 111
Odessa, TX 79761-4252

Mailing address

850 Tower Dr Ste 111
Odessa, TX 79761-4252
Phone (432) 888-4886

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

LicenseStateTypeSpecialty
146670TXMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Imaging Inc Diagnostic Ultrasound CurrentSince Aug 28, 2022 Accepting new patients

Locations

850 Tower Dr
Ste 111
Odessa, TX 79761
Phone (432) 580-7440

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1134847312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 TOWER DR STE 111",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614252",
            "telephone_number": "432-888-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 TOWER DR STE 111",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614252",
            "telephone_number": "432-888-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDWELL",
        "first_name": "NATAUSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "TX",
            "license": "146670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.