NPIMap

Organization Active NPI

Glade Run Medical Associates

  • Rheumatology Physician
  • Kittanning, PA
National Provider Identifier
1184947848
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
GLADE RUN MEDICAL ASSOCIATES
Practice address
400 Medical Arts BLDG
Ste 410
Kittanning, PA 16201-7160
Phone
(724) 543-8867
NPI assigned
Mar 10, 2010
Last updated
Jan 15, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
GLADE RUN MEDICAL ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Authorized official

Name
Patrick Burns
Title
Cfo
Phone
(724) 543-8618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU Primary

Addresses

Primary practice location

400 Medical Arts BLDG
Ste 410
Kittanning, PA 16201-7160

Mailing address

400 Medical Arts BLDG
Ste 410
Kittanning, PA 16201-7160
Phone (724) 543-8867

Other names 1

  • ACMH - Rheumatology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000006 PA Part B Supplier - Clinic/Group Practice 3577696897 Receives reassigned benefits from 40 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Sarver, PA; New Bethlehem, PA; Natrona Heights, PA

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Part of
Glade Run Medical Assoc Inc

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1184947848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEDICAL ARTS BLDG",
            "address_2": "STE 410",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017160",
            "telephone_number": "724-543-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL ARTS BLDG",
            "address_2": "STE 410",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017160",
            "telephone_number": "724-543-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLADE RUN MEDICAL ASSOCIATES",
        "enumeration_date": "2010-03-10",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "724-543-8618"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACMH - Rheumatology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ACMH - Rheumatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.