NPIMap

Organization Active NPI

Glade Run Medical Associates Inc

  • Family Medicine Physician
  • Kittanning, PA
National Provider Identifier
1881820850
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GLADE RUN MEDICAL ASSOCIATES INC
Practice address
1 Nolte Dr
Kittanning, PA 16201-7111
Phone
(724) 543-8670
Fax
(724) 543-8535
NPI assigned
Jun 4, 2009
Last updated
Feb 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Authorized official

Name
Patrick Burns
Title
VP of Finance & Cfo
Phone
(724) 543-8618

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

1 Nolte Dr
Kittanning, PA 16201-7111

Mailing address

1 Nolte Dr
Kittanning, PA 16201-7111
Phone (724) 543-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000006 PA Part B Supplier - Clinic/Group Practice 3577696897 Receives reassigned benefits from 40 practitioners
25 other NPIs on this enrollment
Practice locations: Kittanning, PA; Sarver, PA; New Bethlehem, PA; Natrona Heights, PA

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1881820850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-543-8670",
            "fax_number": "724-543-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-543-8670",
            "fax_number": "724-543-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "VP OF FINANCE & CFO",
        "authorized_official_telephone_number": "724-543-8618"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.