Individual provider Active NPI

Jonathan S McGlothan, M.D.

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1154374973
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01043767A Issued in IN
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

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
200039810CMedicaidIN

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

LicenseStateTypeSpecialty
01043767AINMDOphthalmology Physician
41406KYMDOphthalmology Physician
4301111306MIMDOphthalmology Physician
35.124274OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optical Management Systems, Inc. Single Specialty PastSince Aug 15, 2011 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.

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.

Verify at the official NPI Registry.