Active NPI
Bruce Steven Glickman, DC
- Chiropractor
- Yulee, FL
National Provider Identifier
1417975996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH3341
- Practice address
- 464073 Sr 200
Suite 4
Yulee, FL 32097 - Phone
- (904) 491-1345
- Fax
- (904) 491-1346
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH3341 | FL | Primary |
Addresses
Primary practice location
464073 Sr 200
Suite 4
Yulee, FL 32097
Mailing address
464073 Sr 200
Suite 4
Yulee, FL 32097
Phone (904) 491-1345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 381329100 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278028800000",
"number": "1417975996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "464073 SR 200",
"address_2": "SUITE 4",
"city": "YULEE",
"state": "FL",
"postal_code": "32097",
"telephone_number": "904-491-1345",
"fax_number": "904-491-1346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464073 SR 200",
"address_2": "SUITE 4",
"city": "YULEE",
"state": "FL",
"postal_code": "32097",
"telephone_number": "904-491-1345",
"fax_number": "904-491-1346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLICKMAN",
"first_name": "BRUCE",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2010-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH3341",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "381329100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yulee, FL
- Genesis Health Development, Inc. (Brooks Health Development)
- Georgia Pain Physicians PC
- Joufflie Germain
- Julie Gerrits
- Jariah Gibbs
- Kelly Goss
- Deven J. Goyet, OT
- Great Strides Rehabilitation Inc. (Great Strides Rehabilitation)
- Great Strides Rehabilitation Inc. (Great Strides Rehabilitation)
- Elisha R Greggo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.