Individual provider Active NPI

Ehren Gleckler

  • Family Nurse Practitioner
  • Auburn, GA
National Provider Identifier
1164958484
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN216327 Issued in GA
Practice address
12 7TH St
Auburn, GA 30011-3202
Phone
(770) 848-9320
NPI assigned
May 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN216327 GA Primary

Addresses

Primary practice location

12 7TH St
Auburn, GA 30011-3202

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address egleckler30114@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170809003983 GA Practitioner - Nurse Practitioner 3375814379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

12 7TH St
Auburn, GA 30011-3202
Phone (770) 848-9320

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Urgent Care LLC CurrentSince Nov 5, 2018 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Jul 1, 2017 Accepting new patients

Locations

12 7th St
Auburn, GA 30011
Phone (770) 822-5555

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

852 Dacula Rd
Dacula, GA 30019
Phone (770) 848-9360

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Interoperability endpoints

  • Direct secure messaging: egleckler30114@nghs.gadirect.net

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1164958484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420",
            "fax_number": "770-219-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 7TH ST",
            "city": "AUBURN",
            "state": "GA",
            "postal_code": "300113202",
            "telephone_number": "770-848-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLECKLER",
        "first_name": "EHREN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-05",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN216327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egleckler30114@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12 7th St",
            "city": "Auburn",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300113202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Auburn, GA

Sources for this page

Verify at the official NPI Registry.