Individual provider Active NPI

Elizabeth Marie Gladney, AGACNP-BC

  • Neuroscience Registered Nurse
  • Vacaville, CA
National Provider Identifier
1376109033
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroscience Registered NurseTaxonomy code 163WN0800X
License
95011606 Issued in CA
Practice address
312 Tilden Cir
Vacaville, CA 95688-9485
Phone
(618) 670-0911
NPI assigned
May 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroscience Registered Nurse 163WN0800X 95011606 CA Primary

Addresses

Primary practice location

312 Tilden Cir
Vacaville, CA 95688-9485

Mailing address

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 646-4034

Other identifiers 1

IdentifierTypeStateIssuer
F1584195OtherCADRIVERS LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address egladney@northbay.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200225002673 CA Practitioner - Nurse Practitioner 9436586773 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Feb 1, 2020 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Northbay Healthcare Group CurrentSince Feb 1, 2020 Accepting new patients
Northbay Physicians Surgery Center LLC Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777

1860 Pennsylvania Ave
Ste 230
Fairfield, CA 94533
Phone (707) 646-4000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1376109033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333552",
            "telephone_number": "707-646-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 TILDEN CIR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889485",
            "telephone_number": "618-670-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADNEY",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neuroscience",
            "state": "CA",
            "license": "95011606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "F1584195",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egladney@northbay.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1200 B Gale Wilson Blvd",
            "city": "Fairfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945333552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.