Individual provider Active NPI

Liam Emmett Davis Glowaski, DPT

  • Physical Therapist
  • Pottsville, PA
National Provider Identifier
1407535644
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
495 N Claude a Lord Blvd
Pottsville, PA 17901-2705
Phone
(570) 516-9858
NPI assigned
Jul 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

495 N Claude a Lord Blvd
Pottsville, PA 17901-2705

Mailing address

495 N Claude a Lord Blvd
Pottsville, PA 17901-2705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230827000038 PA Practitioner - Physical Therapist in Private Practice 8628431418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

2211 Quarry Dr
Suite E55
Reading, PA 19609-1161
Phone (570) 516-9858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Aug 7, 2023 Accepting new patients
Integrated Medical Group P C CurrentSince Aug 7, 2023 Accepting new patients
Img PT Physical Therapist Past Accepting new patients

Locations

495 N Claude a Lord Blvd
Pottsville, PA 17901
Phone (570) 516-9858

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

2211 Quarry Dr
Ste E55
West Lawn, PA 19609
Phone (570) 516-9858

Interoperability endpoints

  • Direct secure messaging: lglowaski@imgpc.medentdirect.com

Organizations & group practices 5

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": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1407535644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012705",
            "telephone_number": "570-516-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOWASKI",
        "first_name": "LIAM",
        "middle_name": "EMMETT DAVIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.