Individual provider Active NPI

Christine Doyle Glidden, DC

  • Chiropractor
  • Boston, MA
National Provider Identifier
1891493631
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHI3818 Issued in MA
Practice address
30 Fenway Ste 1
Boston, MA 02215-4016
Phone
(857) 990-3721
Fax
(857) 336-6878
NPI assigned
Feb 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHI3818 MA Primary

Addresses

Primary practice location

30 Fenway Ste 1
Boston, MA 02215-4016

Mailing address

30 Fenway Ste 1
Boston, MA 02215-4016
Phone (857) 990-3721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108003100 MA Practitioner - Chiropractic 0042744351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1914 Centre St
West Roxbury, MA 02132-2535
Phone (617) 323-4377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHI3818MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
Bay State Physical Therapy of Randolph Inc Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
Bay State Physical Therapy of Randolph Inc Chiropractor Past Accepting new patients

Locations

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

1914 Centre St
West Roxbury, MA 02132
Phone (617) 323-4377

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1891493631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FENWAY STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154016",
            "telephone_number": "857-990-3721",
            "fax_number": "857-336-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FENWAY STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154016",
            "telephone_number": "857-990-3721",
            "fax_number": "857-336-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDDEN",
        "first_name": "CHRISTINE",
        "middle_name": "DOYLE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "CHI3818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.