Rachel Burke Glass, D.O.
Individual provider Active NPI Pediatrics Physician · Alma, GA
NPI 1275777971 · NPPES record last updated Jan 14, 2022
Key facts
- NPI
- 1275777971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 066997 (GA)
- Practice address
- 1112 W 12TH St
Alma, GA 31510-1814 - Phone
- (912) 632-8244
- Fax
- (912) 632-7041
- NPI assigned
- Apr 24, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 066997 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Georgia Primary Care, Inc. | Pediatrics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 066997 | GA | Yes |
Addresses
Primary practice location
1112 W 12TH St
Alma, GA 31510-1814
Mailing address
1112 W 12TH St
Alma, GA 31510-1814
Phone (912) 632-8244
Other names
- Rachel Damaris Burke
Other providers in Alma, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.