Elizabeth Ann Gluck

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

4500 Issued in GA

Practice address

250 Hills and Dales Farm Rd
Lagrange, GA 30240-3805

Phone

(762) 323-1145

NPI assigned

Feb 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1497452379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N VIEW POINTE DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302419194",
            "telephone_number": "706-302-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HILLS AND DALES FARM RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403805",
            "telephone_number": "762-323-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCK",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "4500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "4500",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Gesselman
• Hayes Vinson Giddens, AUD
• Bremeka Gilbert, LMSW
• Christopher Blake Glaze
• Niyah Glover
• Robert S Gold, DMD
• Jana Goodman, APRN
• Susan Goodson, DMD
• Kathleen Gordon
• Kenneth D Gordon, MD

• Occupational Therapy Assistant in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Occupational Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.