Active NPI
Angella M. Glidden-Wood, M.D.
- Family Medicine Physician
- Deland, FL
National Provider Identifier
1639443260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME79609
- Practice address
- 909 N Stone St
Deland, FL 32720-2521 - Phone
- (386) 279-7726
- Fax
- (386) 873-2927
- NPI assigned
- Feb 29, 2012
- Last updated
- Jan 26, 2015
- 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 Medicine Physician | 207Q00000X | ME79609 | FL | Primary |
Addresses
Primary practice location
909 N Stone St
Deland, FL 32720-2521
Mailing address
909 N Stone St
Deland, FL 32720-2521
Phone (386) 279-7726
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME79609 | Other | FL | MEDCIAL LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME79609 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422230400000",
"number": "1639443260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 N STONE ST",
"city": "DELAND",
"state": "FL",
"postal_code": "327202521",
"telephone_number": "386-279-7726",
"fax_number": "386-873-2927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 N STONE ST",
"city": "DELAND",
"state": "FL",
"postal_code": "327202521",
"telephone_number": "386-279-7726",
"fax_number": "386-873-2927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLIDDEN-WOOD",
"first_name": "ANGELLA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-29",
"last_updated": "2015-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME79609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCIAL LICENSE",
"identifier": "ME79609",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.