Active NPI
Charles M Glanville, O.D.
- Optometrist
- Cuyahoga Falls, OH
National Provider Identifier
1881779858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2875
- Practice address
- 646 Portage TRL
Cuyahoga Falls, OH 44221-3034 - Phone
- (330) 929-9941
- Fax
- (330) 929-3926
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2875 | OH | Primary |
Addresses
Primary practice location
646 Portage TRL
Cuyahoga Falls, OH 44221-3034
Mailing address
646 Portage TRL
Cuyahoga Falls, OH 44221-3034
Phone (330) 929-9941
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0361504 | Medicaid | OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2875 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357603200000",
"number": "1881779858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "646 PORTAGE TRL",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442213034",
"telephone_number": "330-929-9941",
"fax_number": "339-929-3926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "646 PORTAGE TRL",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442213034",
"telephone_number": "330-929-9941",
"fax_number": "330-929-3926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLANVILLE",
"first_name": "CHARLES",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2013-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "2875",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361504",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cuyahoga Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.