Glenn Blaise Gatipon, MD PHD MBA

Primary specialty

Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X

License

23962 Issued in GA

Practice address

888 Old Mountain Rd NW
Kennesaw, GA 30152-3843

Phone

(770) 426-0102

NPI assigned

Jul 15, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Primary Care Partners, PC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1306939657
  NPD (past)

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1306287750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TOWER RD NE STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609416",
            "telephone_number": "678-581-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 OLD MOUNTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523843",
            "telephone_number": "770-426-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATIPON",
        "first_name": "GLENN",
        "middle_name": "BLAISE",
        "name_prefix": "Dr.",
        "credential": "MD PHD MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "GA",
            "license": "23962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dannielle Lee Gardner, LCSW
• Nikia Lynette Garland, DO
• Eldine Garraud, FNP
• Kayla Nycohl Garris, PHARMD
• Marie Gaspard, RN
• Ariana Michelle Gatti, BCBA
• Sandra Jean Gault, RN057314
• Jenna Gauvreau, RBT
• Linda L Gay
• David Haiwei Ge, MD

• Obesity Medicine (Internal Medicine) Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Obesity Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.