Collier B. Gladin, Jr., M.D., LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

030609 Issued in GA

Legal business name

COLLIER B. GLADIN, JR., M.D., LLC

Practice address

140 Northcrest Blvd.
Macon, GA 31210

Phone

(478) 757-8335

Fax

(478) 757-8353

NPI assigned

Sep 20, 2010

Organization subpart

Yes

Parent organization

COLLIER B. GLADIN, JR. M.D., LLCAs reported in NPPES

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

Authorized official

Name

Dr. Collier B. Gladin Jr., M.D.NPI 1063527430

Title

Owner

Phone

(478) 757-8335

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Collier B Gladin Jr MD Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Part of

Collier B Gladin Jr MD LLC

Locations

Practitioners 6

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

• Collier Branan Gladin Jr., M.D.

  • Family Medicine Physician
  • Macon, GA
  • NPI 1063527430
  Medicare reassignment NPD Authorized official
• Valencia Burleson, FNP

  • Family Nurse Practitioner
  • Griffin, GA
  • NPI 1568973790
  Medicare reassignment NPD
• Salvatore John Dellacona, M.D.

  • Family Medicine Physician
  • Lizella, GA
  • NPI 1063463750
  NPD (past)
• Angela Thornton Lewis, NP-C

  • Family Nurse Practitioner
  • Macon, GA
  • NPI 1841572260
  NPD (past)
• Kimberly Gamble Murdock, NP-C

  • Adult Health Nurse Practitioner
  • Macon, GA
  • NPI 1366716029
  NPD (past)
• Jennifer Marie Grant, PA

  • Physician Assistant
  • Oregon City, OR
  • NPI 1144497736
  NPD (past)

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1780992198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 NORTHCREST BLVD.",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "478-757-8335",
            "fax_number": "478-757-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NORTHCREST BLVD.",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "478-757-8335",
            "fax_number": "478-757-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER B. GLADIN, JR., M.D., LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLLIER B. GLADIN, JR. M.D., LLC",
        "enumeration_date": "2010-09-20",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GLADIN",
        "authorized_official_first_name": "COLLIER",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-757-8335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030609",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "030609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000383446D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "D29570",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collier B Gladin Jr MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• April Nicole Colley, CPNP
• Deborah Lusendia Collier, FNP-C
• Samuel Scott Collier, NP
• Carol Lynn Collings, MD
• Amy Vardeman Collins, PA-C
• Bradley Kelvin Collins, DPT

• Family Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.