Individual provider Active NPI

Hank R. Glass, D.C.

  • Sports Medicine (Family Medicine) Physician
  • Randolph, VT
National Provider Identifier
1538275052
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
0060001089 Issued in VT
Practice address
44 S Main St
Randolph, VT 05060-1381
Phone
(802) 763-8000
Fax
(802) 728-2394
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 0060001089 VT Primary

Addresses

Primary practice location

44 S Main St
Randolph, VT 05060-1381

Mailing address

PO Box 2000
Randolph, VT 05060-2000
Phone (802) 763-8000

Other identifiers 1

IdentifierTypeStateIssuer
1012263MedicaidVT

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

State licenses

LicenseStateTypeSpecialty
0060001089VTMDSports Medicine (Family Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1538275052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050602000",
            "telephone_number": "802-763-8000",
            "fax_number": "802-728-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601381",
            "telephone_number": "802-763-8000",
            "fax_number": "802-728-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "HANK",
        "middle_name": "R.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VT",
            "license": "0060001089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012263",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.