Individual provider Active NPI

Dennis Leo Glaude, CRNA

  • Certified Registered Nurse Anesthetist
  • Macon, GA
National Provider Identifier
1689620536
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN078329 Issued in GA
Practice address
380 Hospital Dr.
Suite 410
Macon, GA 31217-8014
Phone
(706) 282-4200
Fax
(706) 886-8045
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN078329 GA Primary

Addresses

Primary practice location

380 Hospital Dr.
Suite 410
Macon, GA 31217-8014

Mailing address

P.O. Box 2564
Macon, GA 31203
Phone (478) 746-5644

Other identifiers 4

IdentifierTypeStateIssuer
580628385OtherGATRICARE
000547797FMedicaidGA
P00257335OtherGAMEDICARE RAILROAD
003105057AMedicaidGA

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN078329GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Currahee Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Apr 6, 2021 Accepting new patients
Anesthesia Associates of Macon LLP Past Accepting new patients

Locations

125 Heard St
Elberton, GA 30635

163 Hospital Dr
Toccoa, GA 30577
Phone (706) 282-4200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1689620536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2564",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31203",
            "telephone_number": "478-746-5644",
            "fax_number": "478-745-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR.",
            "address_2": "SUITE 410",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312178014",
            "telephone_number": "706-282-4200",
            "fax_number": "706-886-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAUDE",
        "first_name": "DENNIS",
        "middle_name": "LEO",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN078329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "580628385",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000547797F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00257335",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003105057A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.

Verify at the official NPI Registry.