Individual provider Active NPI

Virginia Elizabeth Glockzin, PA-C

  • Physician Assistant
  • Greenville, NC
National Provider Identifier
1497480024
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1006 W H Smith Blvd
Greenville, NC 27834-5051
Phone
(252) 413-6683
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1006 W H Smith Blvd
Greenville, NC 27834-5051

Mailing address

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6683

Other practice location 1

400 Treybrooke Cir Apt 13
Greenville, NC 27834-7742
Phone (501) 628-7074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230201001154 NC Practitioner - Physician Assistant 8022489996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians East PAGroup PAC ID 1850284571, 104 clinicians

Practice addresses (Care Compare)

1006 WH Smith Blvd
Greenville, NC 27834-5194
Phone (252) 413-6683

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians East, PA CurrentSince Jan 24, 2023 Accepting new patients

Locations

1850 W Arlington Blvd
Greenville, NC 27834
Phone (252) 413-6641

1006 Wh Smith Blvd
Greenville, NC 27834
Phone (252) 413-6683

Interoperability endpoints

  • Direct secure messaging: virginiaglockzin@pepa.medalliesdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1497480024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-413-6683",
            "fax_number": "252-756-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345051",
            "telephone_number": "252-413-6683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Treybrooke Cir Apt 13",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278347742",
            "country_code": "US",
            "telephone_number": "501-628-7074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOCKZIN",
        "first_name": "VIRGINIA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.