Glen Howard Hastings, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301 406148 Issued in MI

Practice address

2990 Niles Rd
Saint Joseph, MI 49085-8607

Phone

(269) 983-3368

Fax

(269) 983-2758

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: ghastings7594@lakeland.midirect.net

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1669439550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858607",
            "telephone_number": "269-983-3368",
            "fax_number": "269-983-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858607",
            "telephone_number": "269-983-3368",
            "fax_number": "269-983-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "GLEN",
        "middle_name": "HOWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301 406148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4170368  10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.

Verify at the official NPI Registry.