Active NPI
Cynthia L Colglazier, NP
- Family Nurse Practitioner
- Gosport, IN
National Provider Identifier
1619245909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71003751
- Practice address
- 7 E Main St
Gosport, IN 47433-7034 - Phone
- (812) 879-4222
- Fax
- (812) 879-4834
- NPI assigned
- Dec 1, 2011
- Last updated
- Dec 3, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71003751 | IN | Primary |
Addresses
Primary practice location
7 E Main St
Gosport, IN 47433-7034
Mailing address
PO Box 1329
Bloomington, IN 47402-1329
Phone (812) 879-4222
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ccolglazier@direct.iuhealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71003751 | IN | MD | Family Nurse Practitioner |
Interoperability endpoints
- ccolglazier@direct.iuhealth.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1619245909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1329",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474021329",
"telephone_number": "812-879-4222",
"fax_number": "812-879-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 E MAIN ST",
"city": "GOSPORT",
"state": "IN",
"postal_code": "474337034",
"telephone_number": "812-879-4222",
"fax_number": "812-879-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLGLAZIER",
"first_name": "CYNTHIA",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-01",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71003751",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ccolglazier@direct.iuhealth.org",
"affiliation": "N",
"address_1": "7 E Main St",
"city": "Gosport",
"state": "IN",
"country_code": "US",
"postal_code": "474337034",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gosport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.