K.C. Gleaton

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

Practice address

10320 Little Patuxent Pkwy Ste 200
Columbia, MD 21044-3344

Phone

(973) 510-2100

NPI assigned

Sep 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Ultima II, LLC

  • Supports Brokerage Agency
  • Columbia, MD
  • NPI 1689398455
  NPD Authorized official
• Ultima, LLC

  • Non-Pharmacy Dispensing Site
  • Columbia, MD
  • NPI 1235848052
  NPD Authorized official
• Ultima, LLC

  • Mail Order Pharmacy
  • Columbia, MD
  • NPI 1679297931

  Non-Pharmacy Dispensing Site

  NPD Authorized official

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1760104434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 JESSUP RD UNIT 932",
            "city": "JESSUP",
            "state": "MD",
            "postal_code": "207947545",
            "telephone_number": "973-510-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 LITTLE PATUXENT PKWY STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443344",
            "telephone_number": "973-510-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEATON",
        "first_name": "K.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "UltimaHealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2851 Jessup Rd Unit 932",
            "city": "Jessup",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207947545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Dawn Glass, R.N.
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• Hannah Glassman, LMSW
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• Shaneeka Gleaton
• Susan J Gleazer, MD
• Glen Burnie Physical Therapy & Sportscare, LLC
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• Glen Burnie Physical Therapy & Sportscare, LLC

• Mail Order Pharmacy in Columbia, MD
• Providers in Columbia, MD by specialty
• Mail Order Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.