Individual provider Active NPI

Gina Gladson, MSN FNP-C

  • Nurse Practitioner
  • Marion, IL
National Provider Identifier
1437699147
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209014757 Issued in IL
Practice address
3412 Office Park Dr
Marion, IL 62959-6477
Phone
(618) 993-0404
Fax
(618) 993-1717
NPI assigned
Feb 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209014757 IL Primary

Addresses

Primary practice location

3412 Office Park Dr
Marion, IL 62959-6477

Mailing address

3412 Office Park Dr
Marion, IL 62959-6477
Phone (618) 993-0404

Other names 1

  • Gina Schatte Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20191101001048 IL Practitioner - Nurse Practitioner 2567794019 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209014757ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Nov 4, 2019 Accepting new patients
Pediatric Group LLC Past Accepting new patients
Pediatric Group LLC Past Accepting new patients
Heartland Pediatric Clinic Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 Rushing Dr
Herrin, IL 62948
Phone (618) 993-3300

3412 Office Park Dr
Marion, IL 62959
Phone (618) 993-0404

Interoperability endpoints

  • Direct secure messaging: gina.gladson.1@11869.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11869/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ggladson6819@sih.direct-ci.com

Organizations & group practices 4

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": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1437699147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 OFFICE PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596477",
            "telephone_number": "618-993-0404",
            "fax_number": "618-993-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 OFFICE PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596477",
            "telephone_number": "618-993-0404",
            "fax_number": "618-993-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSON",
        "first_name": "GINA",
        "credential": "MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "SCHATTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.