Individual provider Active NPI

Emily Gladstone, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1760860654
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101026517 Issued in MI
Practice address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone
(616) 840-8000
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101026517 MI Primary

Addresses

Primary practice location

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Mailing address

8705 Carlisle Dr SW
Byron Center, MI 49315-8185
Phone (248) 882-0527

Other practice location 1

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-4486

Other practice location 2

420 Delaware Street Southeast
Mmc297
Minneapolis, MN 55455
Phone (651) 229-3819

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address egladstone115029@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209000169 MI Practitioner - Physical Medicine and Rehabilitation 2163724519 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101026517MIMDPhysical Medicine & Rehabilitation Physician

Interoperability endpoints

  • Direct secure messaging: egladstone115029@direct.covenanthealthcare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1760860654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8705 CARLISLE DR SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158185",
            "telephone_number": "248-882-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-4486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Delaware Street Southeast",
            "address_2": "MMC297",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55455",
            "country_code": "US",
            "telephone_number": "651-229-3819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLADSTONE",
        "first_name": "EMILY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101026517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egladstone115029@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "235 Wealthy St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495035247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.