NPIMap

Organization Active NPI

Glacier Hills, Inc.

  • Physical Therapist
  • Ann Arbor, MI
National Provider Identifier
1780924639
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GLACIER HILLS, INC.
Practice address
1200 Earhart Rd
Ann Arbor, MI 48105-2768
Phone
(734) 929-6721
Fax
(734) 213-9180
NPI assigned
Feb 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Pamela Sue Latovick
Title
VP Reimbursement
Phone
(734) 343-6628

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

1200 Earhart Rd
Ann Arbor, MI 48105-2768

Mailing address

1200 Earhart Rd
Ann Arbor, MI 48105-2768
Phone (734) 929-6721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130906000382 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9537172382 Receives reassigned benefits from 7 practitioners
Practice locations: Ann Arbor, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Baxter Regional Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

400 S College St
Mountain Home, AR 72653
Phone (870) 425-5145

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1780924639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EARHART RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052768",
            "telephone_number": "734-929-6721",
            "fax_number": "734-213-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EARHART RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052768",
            "telephone_number": "734-929-6721",
            "fax_number": "734-213-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER HILLS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "LATOVICK",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "VP REIMBURSEMENT",
        "authorized_official_telephone_number": "734-343-6628"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.