Active NPI
Courtney Gladwell, CPNP-PC
- Pediatrics Physician
- Tuscaloosa, AL
National Provider Identifier
1134885189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 1-150741
- Practice address
- 4700 Rice Mine Rd NE
Tuscaloosa, AL 35406-2647 - Phone
- (205) 614-5628
- NPI assigned
- Nov 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 1-150741 | AL | Primary |
Addresses
Primary practice location
4700 Rice Mine Rd NE
Tuscaloosa, AL 35406-2647
Mailing address
711 Greenbriar Dr
Northport, AL 35473-5234
Phone (205) 310-1497
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-150741 | AL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1134885189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 GREENBRIAR DR",
"city": "NORTHPORT",
"state": "AL",
"postal_code": "354735234",
"telephone_number": "205-310-1497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 RICE MINE RD NE",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354062647",
"telephone_number": "205-614-5628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLADWELL",
"first_name": "COURTNEY",
"credential": "CPNP-PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "1-150741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.