Individual provider Active NPI

Jason John Gladson, D.M.D.

  • Dentist
  • Nashville, IL
National Provider Identifier
1225359110
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019026769 Issued in IL
Practice address
282 S Mill St
Nashville, IL 62263-1833
Phone
(618) 327-4422
Fax
(618) 327-4423
NPI assigned
Jun 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019026769 IL Primary

Addresses

Primary practice location

282 S Mill St
Nashville, IL 62263-1833

Mailing address

282 S Mill St
Nashville, IL 62263-1833
Phone (618) 327-4422

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019026769ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1225359110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 S MILL ST",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631833",
            "telephone_number": "618-327-4422",
            "fax_number": "618-327-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 S MILL ST",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631833",
            "telephone_number": "618-327-4422",
            "fax_number": "618-327-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSON",
        "first_name": "JASON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.