Active NPI
Brian A Glass, MD
- Obstetrics & Gynecology Physician
- Dalton, GA
National Provider Identifier
1265429146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 032911
- Practice address
- 1109 Burleyson Rd
Suite 205
Dalton, GA 30720-3094 - Phone
- (706) 428-3822
- Fax
- (706) 428-3864
- NPI assigned
- Oct 5, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 032911 | GA | Primary |
Addresses
Primary practice location
1109 Burleyson Rd
Suite 205
Dalton, GA 30720-3094
Mailing address
1109 Burleyson Rd Ste 205
Dalton, GA 30720-3094
Phone (706) 428-3822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52255730001 | Other | GA | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2013 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian Glass MD OB/GYN | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- Dalton, GA
- NPI 1992903165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265429146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 BURLEYSON RD STE 205",
"city": "DALTON",
"state": "GA",
"postal_code": "307203094",
"telephone_number": "706-428-3822",
"fax_number": "706-428-3864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 BURLEYSON RD",
"address_2": "SUITE 205",
"city": "DALTON",
"state": "GA",
"postal_code": "307203094",
"telephone_number": "706-428-3822",
"fax_number": "706-428-3864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "BRIAN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "GA",
"license": "032911",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "52255730001",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.