Individual provider Active NPI

Robert Gladstone, DC

  • Chiropractor
  • Melville, NY
National Provider Identifier
1467643973
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X39745 Issued in NY
Practice address
2474 New York Ave
Melville, NY 11747-1109
Phone
(516) 721-8720
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X39745 NY Primary

Addresses

Primary practice location

2474 New York Ave
Melville, NY 11747-1109

Mailing address

2474 New York Ave
Melville, NY 11747-1109
Phone (516) 721-8720

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
X39745NYMDChiropractor
003974NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1467643973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 NEW YORK AVE",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117471109",
            "telephone_number": "516-721-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 NEW YORK AVE",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117471109",
            "telephone_number": "516-721-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSTONE",
        "first_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X39745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.