Active NPI
Laura Roth Glover, PA-C
- Physician Assistant
- Hampton, VA
National Provider Identifier
1356576243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110002939
- Practice address
- 17 Manhattan SQ
Hampton, VA 23666-5843 - Phone
- (757) 838-8030
- Fax
- (757) 838-8413
- NPI assigned
- May 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110002939 | VA | Primary |
Addresses
Primary practice location
17 Manhattan SQ
Hampton, VA 23666-5843
Mailing address
17 Manhattan SQ
Hampton, VA 23666-5843
Phone (757) 838-8030
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110002939 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alexandria Associates in Dermatology, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dermatology Physician
- Alexandria, VA
- NPI 1043389331
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242777600000",
"number": "1356576243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MANHATTAN SQ",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665843",
"telephone_number": "757-838-8030",
"fax_number": "757-838-8413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 MANHATTAN SQ",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236665843",
"telephone_number": "757-838-8030",
"fax_number": "757-838-8413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "LAURA",
"middle_name": "ROTH",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-20",
"last_updated": "2009-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110002939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.