Daniel Glaze, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61088074 Issued in WA

Practice address

510 E Amende Dr
Odessa, WA 99159-7003

Phone

(509) 982-2614

NPI assigned

Aug 12, 2020

Last updated

Apr 20, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Quinault Indian Nation

  dba Quinault Wellness Center

  • Student in an Organized Health Care Education/Training Program
  • Aberdeen, WA
  • NPI 1134842636

  TX

  Medicare reassignment NPD
• Quinault Indian Nation

  dba Quinault Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aberdeen, WA
  • NPI 1124860283
  NPD
• Lincoln County Public Hospital District 1

  dba Odessa Rural Health Clinic

  • Rural Health Clinic/Center
  • Odessa, WA
  • NPI 1023122520
  NPD (past)

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1740891829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "ODESSA",
            "state": "WA",
            "postal_code": "991590190",
            "telephone_number": "509-982-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E AMENDE DR",
            "city": "ODESSA",
            "state": "WA",
            "postal_code": "991597003",
            "telephone_number": "509-982-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZE",
        "first_name": "DANIEL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61088074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dglaze@omhc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Odessa Memorial Healthcare Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "502 E Amende Dr",
            "city": "Odessa",
            "state": "WA",
            "country_code": "US",
            "postal_code": "991597003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Condon Dental Services (Odessa Dental Clinic)
• James T. Dedeaux Jr., MSW
• Eldridge Chiropractic PS
• Troy D. Eldridge Sr., D.C.
• Deborah A Fogg, NP
• Gregg Liedtka DMD PLLC (Odessa Dental Clinic)
• Lincoln County Public Hospital District 1 (Odessa Rural Health Clinic)
• Lincoln County Public Hospital District 1 (Odessa Memorial Healthcare Center)
• Lincoln County Public Hospital District 1 (Quail Court)
• Lincoln County Public Hospital District 1 (Odessa Memorial Healthcare Center)

• Family Nurse Practitioner in Odessa, WA
• Providers in Odessa, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.