Individual provider Active NPI

Glenn Mark McAlpin, MD

  • Surgery Physician
  • Newnan, GA
National Provider Identifier
1710052105
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
37865 Issued in GA
Practice address
28 Roscoe Rd
Newnan, GA 30263-1112
Phone
(678) 656-3054
Fax
(770) 502-6530
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME126137 FL
Surgical Critical Care Physician 2086S0102X ME126137 FL
Surgery Physician 208600000X 37865 GA Primary

Addresses

Primary practice location

28 Roscoe Rd
Newnan, GA 30263-1112

Mailing address

28 Roscoe Rd
Newnan, GA 30263-1112
Phone (678) 656-3054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050809000401 GA Practitioner - General SurgeryPractitioner - Family PracticePractitioner - Vascular Surgery 9234168386
I20200417001589 NC Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 9234168386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME126137FLMDSurgery Physician
37865GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Sep 27, 2019 Accepting new patients
Tift Regional Health System, Inc. CurrentSince Sep 27, 2019 Accepting new patients

Locations

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

Interoperability endpoints

  • Direct secure messaging: glenn.mcalpin.1@9582.direct.athenahealth.com

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1710052105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ROSCOE RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631112",
            "telephone_number": "678-656-3054",
            "fax_number": "770-502-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ROSCOE RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631112",
            "telephone_number": "678-656-3054",
            "fax_number": "770-502-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALPIN",
        "first_name": "GLENN",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME126137",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME126137",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "37865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.