Active NPI
Mandie L Gleason, LMT
- Specialist
- Fort Collins, CO
National Provider Identifier
1770901183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- COMT 13577
- Practice address
- 420 S Howes St
Suite a-105
Fort Collins, CO 80521-2871 - Phone
- (505) 231-0984
- NPI assigned
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | COMT 13577 | CO | Primary |
Addresses
Primary practice location
420 S Howes St
Suite a-105
Fort Collins, CO 80521-2871
Mailing address
2740 Iowa Dr Unit 101
Fort Collins, CO 80525-4766
Phone (505) 231-0984
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COMT 13577 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399852800000",
"number": "1770901183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 IOWA DR UNIT 101",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805254766",
"telephone_number": "505-231-0984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 S HOWES ST",
"address_2": "SUITE A-105",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805212871",
"telephone_number": "505-231-0984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLEASON",
"first_name": "MANDIE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-02",
"last_updated": "2014-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "COMT 13577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.