Individual provider Active NPI

Andrea Lynn Glasson, PTA

  • Physical Therapy Assistant
  • Cape Coral, FL
National Provider Identifier
1821237264
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 19119 Issued in FL
Practice address
413 Del Prado Blvd
Suite 201
Cape Coral, FL 33990-5713
Phone
(239) 772-5577
Fax
(239) 772-1658
NPI assigned
Feb 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 19119 FL Primary

Addresses

Primary practice location

413 Del Prado Blvd
Suite 201
Cape Coral, FL 33990-5713

Mailing address

413 Del Prado Blvd
Suite 201
Cape Coral, FL 33990-5713
Phone (239) 772-5577

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

LicenseStateTypeSpecialty
PTA 19119FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1821237264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 DEL PRADO BLVD",
            "address_2": "SUITE 201",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339905713",
            "telephone_number": "239-772-5577",
            "fax_number": "239-772-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 DEL PRADO BLVD",
            "address_2": "SUITE 201",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339905713",
            "telephone_number": "239-772-5577",
            "fax_number": "239-772-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSON",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 19119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.