Individual provider Active NPI

S. Glen Neale, MD

  • Orthopaedic Surgery Physician
  • Morrisville, VT
National Provider Identifier
1366465429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0420008384 Issued in VT
Practice address
528 Washington Hwy
Morrisville, VT 05661-8973
Phone
(802) 888-8840
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0420008384 VT Primary

Addresses

Primary practice location

528 Washington Hwy
Morrisville, VT 05661-8973

Mailing address

528 Washington Hwy
Morrisville, VT 05661-8973

Other identifiers 2

IdentifierTypeStateIssuer
00018233OtherVTBLUE CROSS
OVN0158MedicaidVT

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

State licenses

LicenseStateTypeSpecialty
0420008384VTMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366465429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 WASHINGTON HWY",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056618973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 WASHINGTON HWY",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056618973",
            "telephone_number": "802-888-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEALE",
        "first_name": "S.",
        "middle_name": "GLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VT",
            "license": "0420008384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00018233",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0158",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.