Tara Gleaves, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1727 Issued in OK

Practice address

3500 S Western Ave
Oklahoma City, OK 73109-2413

Phone

(405) 632-5565

Fax

(405) 632-3538

NPI assigned

Apr 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Laser Spine Institute, LLC

  • Specialist
  • Tampa, FL
  • NPI 1265483895
  NPD (past)
• Laser Spine Institute, LLC

  • Clinic/Center
  • Cincinnati, OH
  • NPI 1467844076
  NPD (past)

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1801061353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731092413",
            "telephone_number": "405-632-5565",
            "fax_number": "405-632-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731092413",
            "telephone_number": "405-632-5565",
            "fax_number": "405-632-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEAVES",
        "first_name": "TARA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Glass
• Kerri Lynn Glass, RN
• Neil Morgan Glass, DDS, MD
• Jawaunn Quindell Glaze Sr.
• Melissa Gleason, PA-C
• Todd Russell Gleaves, M.D.
• Alexandria Youree Glendenning, PA-C
• Chad Glenn, MD
• Chasity T Glenn
• Deana Glenn

• Medical Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.