NPIMap

Organization Active NPI

Mark O Gladstein MD PLLC

  • Orthopaedic Surgery Physician
  • Louisville, KY
National Provider Identifier
1710102629
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MARK O GLADSTEIN MD PLLC
Practice address
250 E Liberty St
Suite 1005
Louisville, KY 40202-1538
Phone
(502) 589-4448
Fax
(502) 589-1209
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Dr. Mark O Gladstein, M.D.
Title
Physician
Phone
(502) 589-4448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

250 E Liberty St
Suite 1005
Louisville, KY 40202-1538

Mailing address

250 E Liberty St
Suite 1005
Louisville, KY 40202-1538
Phone (502) 589-4448

Other identifiers 5

IdentifierTypeStateIssuer
20041432OtherRR MEDICARE
50009936MedicaidKY
64144546MedicaidKY
9001304600MedicaidKY
1059292MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1710102629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E LIBERTY ST",
            "address_2": "SUITE 1005",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021538",
            "telephone_number": "502-589-4448",
            "fax_number": "502-589-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E LIBERTY ST",
            "address_2": "SUITE 1005",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021538",
            "telephone_number": "502-589-4448",
            "fax_number": "502-589-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK O GLADSTEIN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "GLADSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-589-4448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "20041432",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50009936",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64144546",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001304600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1059292",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.