Paul V McGlynn Jr., P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002538 Issued in GA

Practice address

49TH Medical Group/Sgopf
280 First Street, BLDG 23
Holloman AFB, NM 88330-8273

Phone

(575) 572-7091

Fax

(575) 572-2259

NPI assigned

Apr 24, 2007

Last updated

Apr 9, 2018By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Applecare LLC

  • Urgent Care Clinic/Center
  • Brunswick, GA
  • NPI 1336257179
  NPD
• DMC Physician Group LLC

  • Multi-Specialty Clinic/Center
  • Fitzgerald, GA
  • NPI 1124430020
  NPD
• Early Memorial Hospital

  • Critical Access Hospital
  • Blakely, GA
  • NPI 1548214018
  NPD (past)
• Valdosta Psychiatric Associates, LLC

  • Marriage & Family Therapist
  • Valdosta, GA
  • NPI 1336282144
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1497973325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49TH MEDICAL GROUP/SGOPF",
            "address_2": "280 FIRST STREET, BLDG 23",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273",
            "telephone_number": "575-572-7091",
            "fax_number": "575-572-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49TH MEDICAL GROUP/SGOPF",
            "address_2": "280 FIRST STREET, BLDG 23",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273",
            "telephone_number": "575-572-7091",
            "fax_number": "575-572-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLYNN",
        "first_name": "PAUL",
        "middle_name": "V",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002134B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11529519",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerome Carlos Malimban, PT, DPT
• Nahomi Naxely Martinez, LMSW
• Joseph Marut
• Cathleen Adiva Mauricette, LCSW
• Jana Joel McBurney, NP-C
• Virginia Marie McKinley, LICSW
• Crystal Venice McLeod, LCSW
• Manisha Mills, M.D.
• Gabrielle Moon
• Danielle Moore, OPA

• Physician Assistant in Holloman AFB, NM
• Providers in Holloman AFB, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.