Active NPI
Olivia Glowacki, NP
- Acute Care Nurse Practitioner
- Pontiac, MI
National Provider Identifier
1467960211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4704299666
- Practice address
- 44405 Woodward Ave
Pontiac, MI 48341-5023 - Phone
- (248) 848-3000
- NPI assigned
- Jan 15, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 4704299666 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave
Pontiac, MI 48341-5023
Mailing address
1828 Roszel St
Royal Oak, MI 48067-2379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191015000329 | MI | Order and Referring Only - Nurse Practitioner | 8224369798 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704299666 | MI | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515974400000",
"number": "1467960211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1828 ROSZEL ST",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-848-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOWACKI",
"first_name": "OLIVIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-15",
"last_updated": "2018-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704299666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; 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.