Active NPI
Bruce Glew
- Physical Therapy Assistant
- Massillon, OH
National Provider Identifier
1467796326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2093110
- Practice address
- 1584 1St St NE
Apt a
Massillon, OH 44646-4079 - Phone
- (330) 418-2559
- NPI assigned
- Nov 16, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2093110 | TX | Primary |
Addresses
Primary practice location
1584 1St St NE
Apt a
Massillon, OH 44646-4079
Mailing address
1584 1St St NE
Apt a
Massillon, OH 44646-4079
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2093110 | Other | TX | ECPTOTE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2093110 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1467796326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1584 1ST ST NE",
"address_2": "APT A",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446464079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1584 1ST ST NE",
"address_2": "APT A",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446464079",
"telephone_number": "330-418-2559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLEW",
"first_name": "BRUCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-16",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2093110",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECPTOTE",
"identifier": "2093110",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.