NPIMap

Organization Active NPI

Glade Run Medical Associates, Inc.

  • Pain Medicine Physician
  • Kittanning, PA
National Provider Identifier
1558727792
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
GLADE RUN MEDICAL ASSOCIATES, INC.
Practice address
1 Nolte Dr
Kittanning, PA 16201-7111
Phone
(724) 543-8626
Fax
(724) 543-8736
NPI assigned
Jan 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Mr. Patrick Burns
Title
Cfo & VP Finance
Phone
(724) 543-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X PA Primary

Addresses

Primary practice location

1 Nolte Dr
Kittanning, PA 16201-7111

Mailing address

700 Medical Arts BLDG
Suite 710
Kittanning, PA 16201-7141
Phone (724) 543-8622

Other names 1

  • Pain Management Associates of Armstrong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000006 PA Part B Supplier - Clinic/Group Practice 3577696897 Receives reassigned benefits from 40 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Sarver, PA; New Bethlehem, PA; Natrona Heights, PA

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1558727792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MEDICAL ARTS BLDG",
            "address_2": "SUITE 710",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017141",
            "telephone_number": "724-543-8622",
            "fax_number": "724-543-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-543-8626",
            "fax_number": "724-543-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CFO & VP FINANCE",
        "authorized_official_telephone_number": "724-543-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Management Associates of Armstrong",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.