Organization Active NPI

Glover Physical Therapy, PLLC

  • Physical Therapist
  • Cheektowaga, NY
National Provider Identifier
1407034259
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022612 Issued in NY
Legal business name
GLOVER PHYSICAL THERAPY, PLLC
Practice address
3620 Harlem Road
Suite 2
Cheektowaga, NY 14215-2042
Phone
(716) 446-9500
Fax
(716) 446-9501
NPI assigned
Feb 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Mr. Brian K Glover, PTNPI 1447242342
Title
Physical Therapist/Owner
Phone
(716) 446-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 022612 NY Primary

Addresses

Primary practice location

3620 Harlem Road
Suite 2
Cheektowaga, NY 14215-2042

Mailing address

3620 Harlem Road
Suite 2
Cheektowaga, NY 14215-2042
Phone (716) 446-9500

Other identifiers 3

IdentifierTypeStateIssuer
02167366MedicaidNY
000626742002OtherNYBLUE CROSS BLUE SHIELD
BA0242OtherNYCORPORATE PROVIDER ID

Other names 1

  • Glover Physical Therapy and Pain Rehabilitation Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001422 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4284608936 Receives reassigned benefits from 1 practitioner
Practice locations: Cheektowaga, NY; Williamsville, NY

National Provider Directory

National Provider Directory

Locations

600 Pine Ave
Ste 1
Niagara Falls, NY 14301

1829 Maple Rd
Ste 110
Williamsville, NY 14221
Phone (716) 529-6100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1407034259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 HARLEM ROAD",
            "address_2": "SUITE 2",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142152042",
            "telephone_number": "716-446-9500",
            "fax_number": "716-446-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 HARLEM ROAD",
            "address_2": "SUITE 2",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142152042",
            "telephone_number": "716-446-9500",
            "fax_number": "716-446-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOVER PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "716-446-9500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167366",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000626742002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE  PROVIDER ID",
            "identifier": "BA0242",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glover Physical Therapy and Pain Rehabilitation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.