Individual provider Active NPI

Brigid Keane Glackin, M.D.

  • Surgery Physician
  • Springfield, MA
National Provider Identifier
1316936065
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
44092 Issued in MA
Practice address
780 Chestnut St
Suite 14
Springfield, MA 01107-1637
Phone
(413) 788-6456
Fax
(413) 733-4992
NPI assigned
Oct 17, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 44092 MA Primary

Addresses

Primary practice location

780 Chestnut St
Suite 14
Springfield, MA 01107-1637

Mailing address

PO Box 327
Northampton, MA 01061-0327
Phone (413) 788-6456

Other identifiers 1

IdentifierTypeStateIssuer
0168343MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1316936065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010610327",
            "telephone_number": "413-788-6456",
            "fax_number": "413-733-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CHESTNUT ST",
            "address_2": "SUITE 14",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071637",
            "telephone_number": "413-788-6456",
            "fax_number": "413-733-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLACKIN",
        "first_name": "BRIGID",
        "middle_name": "KEANE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "44092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0168343",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.