Active NPI
Glenn S Fitzwater, DC
- Chiropractor
- Gadsden, AL
National Provider Identifier
1649210972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1359
- Practice address
- 113 Hoke Street
Gadsden, AL 35903-1744 - Phone
- (256) 546-3047
- Fax
- (256) 546-7116
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1359 | AL | Primary |
| Chiropractor | 111N00000X | 1671 | OH |
Addresses
Primary practice location
113 Hoke Street
Gadsden, AL 35903-1744
Mailing address
113 Hoke Street
Gadsden, AL 35903-1744
Phone (256) 546-3047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350019263 | Other | GA | RAILROAD MEDICARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1359 | AL | MD | Chiropractor |
| 1671 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322956800000",
"number": "1649210972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 HOKE STREET",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359031744",
"telephone_number": "256-546-3047",
"fax_number": "256-546-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 HOKE STREET",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359031744",
"telephone_number": "256-546-3047",
"fax_number": "256-546-7116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZWATER",
"first_name": "GLENN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2011-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AL",
"license": "1359",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "1671",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "350019263",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gadsden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.