Mark Glasson

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

041249330 Issued in IL

Practice address

7719 Bridlewood Rd
Caledonia, IL 61011-9011

Phone

(815) 222-9242

NPI assigned

Feb 14, 2024

Last updated

Feb 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1164287686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7719 BRIDLEWOOD RD",
            "city": "CALEDONIA",
            "state": "IL",
            "postal_code": "610119011",
            "telephone_number": "815-222-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7719 BRIDLEWOOD RD",
            "city": "CALEDONIA",
            "state": "IL",
            "postal_code": "610119011",
            "telephone_number": "815-222-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSON",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IL",
            "license": "041249330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse First Assistant in Caledonia, IL
• Providers in Caledonia, IL by specialty
• Registered Nurse First Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.