Glen Hatcher Jr., DO

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

633 Issued in NV

Practice address

9455 W Russell Rd
100
Las Vegas, NV 89148-5667

Phone

(702) 896-6043

Fax

(702) 896-9591

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Andersen Eye Associates, PLC

  • Eyewear Supplier
  • Saginaw, MI
  • NPI 1124106489
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1396744983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2598 WINDMILL PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745476",
            "telephone_number": "702-896-6043",
            "fax_number": "702-896-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9455 W RUSSELL RD",
            "address_2": "100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485667",
            "telephone_number": "702-896-6043",
            "fax_number": "702-896-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCHER",
        "first_name": "GLEN",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020-18787",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Hatano
• Breanna Hatch
• Jaylin M Hatch
• John Hatch, MD
• Tyler G Hatch
• Jayonna Z Hatcher
• Jerrie Hatcher
• Naomi Hatcher
• Rickey Hatcher
• Roxana Sirena Hatcher

• Ophthalmology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ophthalmology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.