Individual provider Active NPI

Anthony Nicholas Glaser, MD PHD

  • Family Medicine Physician
  • North Charleston, SC
National Provider Identifier
1578522207
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20323 Issued in SC
Practice address
5401 Netherby Lane
Suite 101
North Charleston, SC 29420
Phone
(843) 408-0092
Fax
(843) 216-0932
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20323 SC Primary

Addresses

Primary practice location

5401 Netherby Lane
Suite 101
North Charleston, SC 29420

Mailing address

917 Houston Northcutt Blvd
Mt Pleasant, SC 29464
Phone (843) 408-0092

Other identifiers 1

IdentifierTypeStateIssuer
203238MedicaidSC

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, Doctor of Philosophy

Interoperability endpoints

  • Direct secure messaging: anthony.glaser.1@14940.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1578522207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 HOUSTON NORTHCUTT BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-408-0092",
            "fax_number": "893-216-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 NETHERBY LANE",
            "address_2": "SUITE 101",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29420",
            "telephone_number": "843-408-0092",
            "fax_number": "843-216-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "ANTHONY",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "20323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203238",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.