Charles Lawrence Glace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13363 Issued in SC

Practice address

2995 Reidville Rd Ste 210
Spartanburg, SC 29301-5631

Phone

(864) 253-8140

Fax

(864) 587-0051

NPI assigned

May 19, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Mary Black Health System LLC

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1083640981
  NPD (past)
• Mary Black Health System LLC

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1992758296
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1730133596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 REIDVILLE RD STE 210",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015631",
            "telephone_number": "864-253-8140",
            "fax_number": "864-587-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLACE",
        "first_name": "CHARLES",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "13363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133634",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE4635019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy Elizabeth Gillespie
• Evelyn M Gilliam, CAC II
• Teresa Gingerella, LPC
• Mary Christina Giovannetti, NP
• Vanessa Giraldo
• Joseph Michael Glendening, DO
• Glenn L Scott, MD, PA
• George Chester Glenn III, MD
• Kelly Glenn
• Saiward Whitener Glenn, MD

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.