Individual provider Active NPI

Carl D Glidden, DO

  • Emergency Medical Services (Emergency Medicine) Physician
  • Muskogee, OK
National Provider Identifier
1508856360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
4160 Issued in OK
Practice address
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone
(918) 781-9466
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4160 OK Primary

Addresses

Primary practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Mailing address

PO Box 17
2424 E. 21St #100
Tulsa, OK 74101-0017
Phone (866) 321-8433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040821000171 OK Practitioner - Emergency Medicine 1153306485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Country Emergency Physicians Group of Tulsa, PLLCGroup PAC ID 0345247052, 107 clinicians

Practice addresses (Care Compare)

1027 E Cherry St
Cushing, OK 74023-4101
Phone (918) 225-2915

Hospital & facility affiliations

  • Hillcrest Hospital Henryetta Hospital, Henryetta, OK, CCN 370183

Merit-based Incentive Payment System (MIPS)

Final score
95.83 of 100Reported as group
Quality
81.24
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4160OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Green Country Emergency Physicians Group of Tulsa PLLC CurrentSince Jan 1, 2023 Accepting new patients
South Central Emergency Services PC Past Accepting new patients
Okmulgee Emergency PLLC Emergency Medical Services Past Accepting new patients
Ahs Oklahoma Physician Group LLC Past Accepting new patients

Locations

1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915

2401 W Main St
Henryetta, OK 74437
Phone (918) 650-1100

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508856360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17",
            "address_2": "2424 E. 21ST #100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741010017",
            "telephone_number": "866-321-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-781-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDDEN",
        "first_name": "CARL",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "4160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.