Active NPI
Ryan Douglas Glackman, ATC
- Athletic Trainer
- Emporia, KS
National Provider Identifier
1770115172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1 Kellogg Cir
Emporia, KS 66801-5087 - Phone
- (620) 341-5955
- NPI assigned
- Feb 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1 Kellogg Cir
Emporia, KS 66801-5087
Mailing address
5235 Picket Dr
Colorado Springs, CO 80918-3621
Phone (719) 510-3805
Other practice location 1
5000 Saint Paul Ave
Lincoln, NE 68504-2760
Phone (719) 510-3805
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1770115172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5235 PICKET DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809183621",
"telephone_number": "719-510-3805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 KELLOGG CIR",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668015087",
"telephone_number": "620-341-5955"
}
],
"practiceLocations": [
{
"address_1": "5000 Saint Paul Ave",
"address_purpose": "LOCATION",
"city": "Lincoln",
"state": "NE",
"postal_code": "685042760",
"country_code": "US",
"telephone_number": "719-510-3805",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLACKMAN",
"first_name": "RYAN",
"middle_name": "DOUGLAS",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-04",
"last_updated": "2023-03-06",
"certification_date": "2023-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emporia, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.