Individual provider Active NPI

Anna Gluckman, WHNP

  • Women's Health Nurse Practitioner
  • St Johnsbury, VT
National Provider Identifier
1811554801
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
101.0134191 Issued in VT
Practice address
501 Portland St
St Johnsbury, VT 05819-2054
Phone
(802) 751-7821
NPI assigned
May 24, 2019
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 101.0134191 VT Primary

Addresses

Primary practice location

501 Portland St
St Johnsbury, VT 05819-2054

Mailing address

784 Hercules Dr
Colchester, VT 05446-8048
Phone (802) 448-9755

Other practice location 1

79 Coventry St
Newport, VT 05855-2206
Phone (802) 334-5822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191118001270 VT Practitioner - Nurse Practitioner 2062844798
I20210727003761 NH Practitioner - Nurse Practitioner 2062844798 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101.0134191VTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maitri Health Care for Women PC Past Accepting new patients
Planned Parenthood of Northern New England PastSince Oct 6, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACAHCA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1811554801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 HERCULES DR",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054468048",
            "telephone_number": "802-448-9755",
            "fax_number": "802-660-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PORTLAND ST",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058192054",
            "telephone_number": "802-751-7821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 Coventry St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "VT",
            "postal_code": "058552206",
            "country_code": "US",
            "telephone_number": "802-334-5822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLUCKMAN",
        "first_name": "ANNA",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VT",
            "license": "101.0134191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.