Individual provider Active NPI

Beth A Gladfelter, NP-C

  • Nurse Practitioner
  • Kokomo, IN
National Provider Identifier
1770519795
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001750A Issued in IN
Practice address
2354 W Boulevard
Kokomo, IN 46902-6069
Phone
(765) 457-4800
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001750A IN Primary

Addresses

Primary practice location

2354 W Boulevard
Kokomo, IN 46902-6069

Mailing address

2354 W Boulevard
Kokomo, IN 46902-6069

Other identifiers 1

IdentifierTypeStateIssuer
200979450MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address beth.gladfelter.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060126000269 IN Practitioner - Nurse Practitioner 2466466727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

2354 W Boulevard
Kokomo, IN 46902-6069
Phone (765) 457-4800

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001750AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Nov 9, 2015 Accepting new patients
St. Vincent Medical Group, Inc. Current Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

2354 W Boulevard
Kokomo, IN 46902
Phone (765) 457-4800

Interoperability endpoints

  • Direct secure messaging: beth.gladfelter.1@7598.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1770519795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2354 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2354 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026069",
            "telephone_number": "765-457-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADFELTER",
        "first_name": "BETH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001750A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200979450",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beth.gladfelter.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "2354 W Boulevard",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469026069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.