Beverly Kay Glasure, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085 Issued in TN

Practice address

820 W Race St
Kingston, TN 37763-2120

Phone

(865) 376-3406

Fax

(865) 376-1559

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Physician Assistant

  NPD (past)
• East Tennessee Neuropathy, PC

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1649511965

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1336287705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 KINGSTON HWY",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377635331",
            "telephone_number": "865-717-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W RACE ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632120",
            "telephone_number": "865-376-3406",
            "fax_number": "865-376-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASURE",
        "first_name": "BEVERLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy D. Fowler, L.C.S.W.
• Wayne King Fritts, DDS
• Leonard Ray Fuqua Jr., DDS, MS
• Kenneth P Fus, RPH
• Kimberly Garrison, PT
• Kimberly Alice Goldborough, OTR
• Catherine Granbery, M.S. CCC-SLP
• Heather Gregg, PMH-NP-BC
• Cameron E. Hamby, PHARM.D.
• Judy Hargis, RN

• All providers in Kingston, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.