NPIMap

Individual provider Active NPI

William Logan Gladney

  • Internal Medicine Physician
  • Boulder, CO
National Provider Identifier
1548722820
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0068967 Issued in CO
Practice address
2750 Broadway St
Boulder, CO 80304-3586
Phone
(303) 440-3082
Fax
(303) 440-3131
NPI assigned
Apr 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Internal Medicine Physician 207R00000X DR.0068967 CO Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3586

Mailing address

2750 Broadway St
Boulder, CO 80304-3586
Phone (303) 440-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922000436 CO Practitioner - Internal MedicinePractitioner - Hospitalist 1456736784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Louisiana State University School of Medicine in New Orleans, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Medical Center, PCGroup PAC ID 4183536204, 86 clinicians
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7610

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Broomfield 80020, CO, CCN 067551
  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Medical Center, P.C. CurrentSince Sep 9, 2022 Accepting new patients
Boulder Medical Center, P.C. Current Accepting new patients
Boulder Medical Center, P.C. CurrentSince Sep 9, 2022 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Nov 7, 2022 Accepting new patients
Medical Center Pharmacy Inc Past Accepting new patients

Locations

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

2750 Broadway St
Boulder, CO 80304
Phone (303) 440-3000

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

Organizations & group practices 6

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1548722820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043586",
            "telephone_number": "303-440-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043586",
            "telephone_number": "303-440-3082",
            "fax_number": "303-440-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADNEY",
        "first_name": "WILLIAM",
        "middle_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0068967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.