Jack Glasser, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19937 Issued in KY

Practice address

1325 Andrea St
Suite 100
Bowling Green, KY 42104-5852

Phone

(270) 901-3454

Fax

(270) 901-3458

NPI assigned

Jun 21, 2005

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1760488191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARYLAND FARMS",
            "address_2": "SUITE 250",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275005",
            "telephone_number": "615-373-7600",
            "fax_number": "866-346-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ANDREA ST",
            "address_2": "SUITE 100",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045852",
            "telephone_number": "270-901-3454",
            "fax_number": "270-901-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSER",
        "first_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "19937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64199375",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080155383",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50006908",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000065732",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glasgow Urgent Clinic, Inc
• Glasgow Urgent Clinic, Inc
• Daniel Todd Glass
• Summer Glass, RBT
• Tasha Glass
• Evan Gleaves
• Abby D Goad
• Colin Goad, DO
• Hannah Kathryn Goebel
• Brooke Elizabeth Goins, MT

• Family Medicine Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.