Active NPI
Michelle Glowacki Hartog, ARNP
- Gerontology Nurse Practitioner
- Winter Park, FL
National Provider Identifier
1740651470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- ARNP1366752
- Practice address
- 4355 Bear Gully Rd
Winter Park, FL 32792-9422 - Phone
- (407) 678-3116
- Fax
- (407) 678-3822
- NPI assigned
- Oct 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | ARNP1366752 | FL | Primary |
Addresses
Primary practice location
4355 Bear Gully Rd
Winter Park, FL 32792-9422
Mailing address
4355 Bear Gully Rd
Winter Park, FL 32792-9422
Phone (407) 678-3116
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP1366752 | FL | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1740651470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4355 BEAR GULLY RD",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327929422",
"telephone_number": "407-678-3116",
"fax_number": "407-678-3822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4355 BEAR GULLY RD",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327929422",
"telephone_number": "407-678-3116",
"fax_number": "407-678-3822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTOG",
"first_name": "MICHELLE",
"middle_name": "GLOWACKI",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-07",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "FL",
"license": "ARNP1366752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.