Active NPI
Glenn R Jaucian, MD
- Cardiovascular Disease Physician
- Clinton, MD
National Provider Identifier
1518958719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- D0020824
- Practice address
- 7700 Old Branch Ave
Suite D203
Clinton, MD 20735-1628 - Phone
- (301) 868-1220
- Fax
- (301) 856-3550
- NPI assigned
- Nov 4, 2005
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | D0020824 | MD | Primary |
Addresses
Primary practice location
7700 Old Branch Ave
Suite D203
Clinton, MD 20735-1628
Mailing address
7700 Old Branch Ave
Suite D203
Clinton, MD 20735-1628
Phone (301) 868-1220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 032791300 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1518958719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 OLD BRANCH AVE",
"address_2": "SUITE D203",
"city": "CLINTON",
"state": "MD",
"postal_code": "207351628",
"telephone_number": "301-868-1220",
"fax_number": "301-856-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7700 OLD BRANCH AVE",
"address_2": "SUITE D203",
"city": "CLINTON",
"state": "MD",
"postal_code": "207351628",
"telephone_number": "301-868-1220",
"fax_number": "301-856-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAUCIAN",
"first_name": "GLENN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MD",
"license": "D0020824",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "032791300",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
- Kellie Jamison, LCSW-C
- Ryan Michael Jander, M.D.
- Lance Stanley Jandreau, MSW, LMSW
- Michael J Janowitz, MD
- Heta S Jasani
- JCP Global Health LLC (Courage Behavioral Health Care Services and Crisis Prevention)
- Patrick Jean-Philippe, M.D.
- Jeducare Services, Inc
- Jeducare Services, Inc
- Kristena Angel Jenkins, L.C.P.C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.