Individual provider Active NPI

Debra Rae Gladden, MD

  • Hospitalist Physician
  • Leavenworth, KS
National Provider Identifier
1518539303
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2021034045 Issued in KS
Practice address
4101 S 4TH St
Leavenworth, KS 66048-5014
Phone
(913) 682-2000
NPI assigned
Jul 12, 2021
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2021034045 MO
Hospitalist Physician 208M00000X 2021034045 KS Primary

Addresses

Primary practice location

4101 S 4TH St
Leavenworth, KS 66048-5014

Mailing address

4101 S 4TH St
Leavenworth, KS 66048-5014
Phone (913) 682-2000

Other practice location 1

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 235-1808

Other practice location 2

4801 E Linwood Blvd
Kansas City, MO 64128-2226
Phone (816) 861-4700

Other names 1

  • Debra Rae Pollak Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210831000141 MO Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 6507262516

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021034045MOMDGeriatric Medicine (Internal Medicine) Physician
2021034045KSMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1518539303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485014",
            "telephone_number": "913-682-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485014",
            "telephone_number": "913-682-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-235-1808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801 E Linwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641282226",
            "country_code": "US",
            "telephone_number": "816-861-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLADDEN",
        "first_name": "DEBRA",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2021034045",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "2021034045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "POLLAK",
            "middle_name": "RAE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.