Individual provider Active NPI

Reginald Dwain Gladish, MD

  • Nephrology Physician
  • Decatur, AL
National Provider Identifier
1831167287
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
18219 Issued in AL
Practice address
1216 Somerville Road SE
Decatur, AL 35601
Phone
(256) 340-0012
Fax
(256) 340-1408
NPI assigned
Mar 10, 2006
Last updated
Feb 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 18219 AL Primary

Addresses

Primary practice location

1216 Somerville Road SE
Decatur, AL 35601

Mailing address

1216 Somerville Road SE
Decatur, AL 35601
Phone (256) 340-0012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000046 AL Practitioner - Nephrology 7517935273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Louisiana State University School of Medicine in Shreveport, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology of North Alabama P.C.Group PAC ID 4082682745, 6 clinicians

Practice addresses (Care Compare)

1216 Somerville Rd SE
Decatur, AL 35601-4335
Phone (256) 340-0012

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18219ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology of North Alabama P.C. Nephrology CurrentSince Jul 12, 1999 Accepting new patients
Home Dialysis of North Alabama Inc. Nephrology PastSince May 18, 2005 Accepting new patients

Locations

1734 Eva Rd NE
Cullman, AL 35055
Phone (256) 734-3055

1890 AL Highway 157
Ste 410
Cullman, AL 35058
Phone (256) 255-0690

1215 7th St SE
Ste 220
Decatur, AL 35601
Phone (256) 340-0012

1216 Somerville Rd SE
Decatur, AL 35601
Phone (256) 340-0012

Interoperability endpoints

  • Direct secure messaging: reginald.gladish@nona.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1831167287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 SOMERVILLE ROAD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35601",
            "telephone_number": "256-340-0012",
            "fax_number": "256-340-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 SOMERVILLE ROAD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35601",
            "telephone_number": "256-340-0012",
            "fax_number": "256-340-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADISH",
        "first_name": "REGINALD",
        "middle_name": "DWAIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "18219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.