Richard Wallace Glass, SA (PA)

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

700 19TH St S
Surgical SVC (112)
Birmingham, AL 35233-1927

Phone

(205) 933-8101

Fax

(205) 558-4732

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447366943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MARY ANN LN",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351734346",
            "telephone_number": "205-467-3475",
            "fax_number": "205-558-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 19TH ST S",
            "address_2": "SURGICAL SVC (112)",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331927",
            "telephone_number": "205-933-8101",
            "fax_number": "205-558-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "RICHARD",
        "middle_name": "WALLACE",
        "name_prefix": "Mr.",
        "credential": "SA (PA)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Mathew Glasgow, MD PHD
• Richard David Glasgow, M.D.
• Isabelle Grace Glass
• Katherine Ann Glass
• Rachel Glass
• Steven Benjamin Glass
• Kyle Glasser
• Stephen Paul Glasser, MD
• Kayla R Glaves, CRNA
• Lashera A Glaze

• Surgical Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Surgical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.