Madeline Rene Glazos, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

4018 Issued in MN

Practice address

5354 Parkdale Dr
St Louis Park, MN 55416-1603

Phone

(320) 267-0585

NPI assigned

Jan 9, 2019

Sex

Female

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

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emily Program P C

  dba The Emily Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1528165065
  Medicare reassignment NPD
• Emily Program PC

  dba The Emily Program

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1154696698
  NPD (past)

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1316410624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 6TH ST E APT 1107",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011976",
            "telephone_number": "320-267-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 PARKDALE DR",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161603",
            "telephone_number": "320-267-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZOS",
        "first_name": "MADELINE",
        "middle_name": "RENE",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A Ginn, CRNA
• Maggie Gintz
• Jane Giovannetti, CRNA
• Colton Charles Gits, M.D.
• Peter William Gjevre, MD
• Grace Anna Gleisner
• James Lawrence Goad, PHARM D
• Robert F Goblirsch, MD
• Christina Lee Goerdt, MSED, LPCC
• Delaney Elizabeth Goetz

• Registered Dietitian in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.