Ivan Glotov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1240 Eagles Landing Pkwy Ste 300
Stockbridge, GA 30281-5173

Phone

(770) 506-4350

Fax

(770) 506-9860

NPI assigned

Apr 11, 2025

Sex

Male

Sole proprietor

No

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

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

Specialty

Physician Assistant

Education

Mercer University School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Piedmont Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1114317062
  Medicare reassignment Care Compare group
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Newnan, GA
  • NPI 1851937114
  Medicare reassignment
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Evans, GA
  • NPI 1679251920
  NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Bethlehem, GA
  • NPI 1801508791
  NPD

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

• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1255126124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 INTERSTATE NORTH CIR SE STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392296",
            "telephone_number": "678-996-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 300",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-506-4350",
            "fax_number": "770-506-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOTOV",
        "first_name": "IVAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Garfield Glenn, PTA
• Kevin A Glenn, MMSC, PA
• Global Research Holdings LLC
• Global Therapy Services, LLC
• Glory Health Care and in Home Services
• Shontreka Akisha Glover, NP
• Tiffany Glover, LPC
• Megan Goeken, OTRL
• Gofs Stockbridge
• Nancy Gogins, LPC

• Physician Assistant in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.