Active NPI
Jonathan Glavich, OTR/L
- Occupational Therapist
- Fuquay Varina, NC
National Provider Identifier
1427768134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 15274
- Practice address
- 1221 Broad St
Fuquay Varina, NC 27526-3602 - Phone
- (919) 552-4580
- NPI assigned
- Dec 5, 2022
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 15274 | NC | Primary |
Addresses
Primary practice location
1221 Broad St
Fuquay Varina, NC 27526-3602
Mailing address
105 Barningham CT
Cary, NC 27519-5505
Phone (919) 744-7852
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": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1427768134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 BARNINGHAM CT",
"city": "CARY",
"state": "NC",
"postal_code": "275195505",
"telephone_number": "919-744-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 BROAD ST",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275263602",
"telephone_number": "919-552-4580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAVICH",
"first_name": "JONATHAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-05",
"last_updated": "2022-12-05",
"certification_date": "2022-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "15274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.