Individual provider Active NPI

Alicia B Glassford, LD

  • Registered Dietitian
  • Lawrenceville, GA
National Provider Identifier
1760734164
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD002945 Issued in GA
Practice address
758 Old Norcross Rd
Suite 175
Lawrenceville, GA 30046-3385
Phone
(770) 339-1387
Fax
(770) 962-7868
NPI assigned
Oct 9, 2012
Last updated
Oct 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD002945 GA Primary

Addresses

Primary practice location

758 Old Norcross Rd
Suite 175
Lawrenceville, GA 30046-3385

Mailing address

758 Old Norcross Rd
Suite 175
Lawrenceville, GA 30046-3385
Phone (770) 339-1387

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD002945GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Endocrinology and Diabetes, PC CurrentSince Oct 1, 2012 Accepting new patients
Openloop Healthcare Partners PC Dietitian, Registered PastSince Oct 1, 2012 Accepting new patients

Locations

758 Old Norcross Rd
Ste 175
Lawrenceville, GA 30046
Phone (770) 339-1387

771 Old Norcross Rd
Ste 200
Lawrenceville, GA 30046
Phone (770) 339-1387

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.400261

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1760734164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD",
            "address_2": "SUITE 175",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463385",
            "telephone_number": "770-339-1387",
            "fax_number": "770-962-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD",
            "address_2": "SUITE 175",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463385",
            "telephone_number": "770-339-1387",
            "fax_number": "770-962-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSFORD",
        "first_name": "ALICIA",
        "middle_name": "B",
        "credential": "LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD002945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.