Individual provider Active NPI

Michelle R Glowicki, PA C

  • Physician Assistant
  • Warrenton, VA
National Provider Identifier
1417986100
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
110000014 Issued in VA
Practice address
52 W Shirley Ave
Warrenton, VA 20186
Phone
(540) 347-9220
Fax
(540) 347-0342
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 110000014 VA Primary

Addresses

Primary practice location

52 W Shirley Ave
Warrenton, VA 20186

Mailing address

52 W Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100831000717 VA Practitioner - Physician Assistant 0042334831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Orthopaedic Associates PCGroup PAC ID 6800885310, 39 clinicians

Practice addresses (Care Compare)

52 W Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
110000014VAMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1417986100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W SHIRLEY AVE",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863008",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W SHIRLEY AVE",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "20186",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOWICKI",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "110000014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.