Active NPI
Jonathan S McGlothan, M.D.
- Ophthalmology Physician
- Chicago, IL
National Provider Identifier
1154374973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01043767A
- Practice address
- 405 N Wabash Ave Ste P2E
Chicago, IL 60611-3591 - Phone
- (312) 955-0071
- NPI assigned
- May 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 35.124274 | OH | |
| Ophthalmology Physician | 207W00000X | 41406 | KY | |
| Ophthalmology Physician | 207W00000X | 4301111306 | MI | |
| Ophthalmology Physician | 207W00000X | 01043767A | IN | Primary |
Addresses
Primary practice location
405 N Wabash Ave Ste P2E
Chicago, IL 60611-3591
Mailing address
15273 Slateford Rd
Noblesville, IN 46062-7712
Phone (317) 267-9014
Other practice location 1
3498 S 4th St
Terre Haute, IN 47802-4168
Phone (812) 478-5550
Other practice location 2
15273 Slateford Rd
Noblesville, IN 46062-7712
Phone (317) 267-9014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200039810C | Medicaid | IN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01043767A | IN | MD | Ophthalmology Physician |
| 41406 | KY | MD | Ophthalmology Physician |
| 4301111306 | MI | MD | Ophthalmology Physician |
| 35.124274 | OH | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optical Management Systems, Inc. | Single Specialty | Past | Accepting new patients |
| Chicago Lasik Center, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Ophthalmologic Surgery Clinic/Center
- Chicago, IL
- NPI 1477036671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1154374973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15273 SLATEFORD RD",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460627712",
"telephone_number": "317-267-9014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 N WABASH AVE STE P2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113591",
"telephone_number": "312-955-0071"
}
],
"practiceLocations": [
{
"address_1": "3498 S 4th St",
"address_purpose": "LOCATION",
"city": "Terre Haute",
"state": "IN",
"postal_code": "478024168",
"country_code": "US",
"telephone_number": "812-478-5550",
"fax_number": "812-478-5858",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15273 Slateford Rd",
"address_purpose": "LOCATION",
"city": "Noblesville",
"state": "IN",
"postal_code": "460627712",
"country_code": "US",
"telephone_number": "317-267-9014",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCGLOTHAN",
"first_name": "JONATHAN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "OH",
"license": "35.124274",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "KY",
"license": "41406",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "4301111306",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01043767A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200039810C",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.