Glen A Gabrielson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00012449 Issued in AL

Practice address

1891 Honeysuckle Rd
Ste C2
Dothan, AL 36305

Phone

(334) 794-6504

Fax

(334) 793-4452

NPI assigned

May 9, 2006

Last updated

May 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• bcbs alabama network 01H0
• bcbs alabama network 01C0
• bcbs alabama network 01E0
• bcbs alabama network 01A0
• bcbs alabama network 01B0
• bcbs alabama network 01G0

Interoperability endpoints

• Direct secure messaging: glen_gabrielson@yourcarecommunity.org

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.

• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  Medicare reassignment NPD
• Southland 806 Hospitalist PLLC

  dba Medical Center of Barbour Hospitalist

  • Emergency Medicine Physician
  • Eufaula, AL
  • NPI 1033803424
  Medicare reassignment NPD
• The Health Care Authority of the City of Eufaula

  dba Medical Center Barbour

  • Critical Access Hospital
  • Eufaula, AL
  • NPI 1730692641
  Medicare reassignment NPD
• Glen Gabrielson

  dba Dothan Family Practice

  • Family Medicine Physician
  • Dothan, AL
  • NPI 1427210491
  Authorized official Same address or phone
• Medmark Treatment Centers of Alabama, Inc.

  dba Medmark Treatment Centers- Dothan

  • Methadone Clinic
  • Newton, AL
  • NPI 1114398799
  NPD
• Northern Alabama Physicians, LLP

  • Hospitalist Physician
  • Enterprise, AL
  • NPI 1952845711
  NPD
• The Health Care Authority of the City of Eufaula

  dba Medical Center Barbour Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Eufaula, AL
  • NPI 1801309711
  NPD
• Triad of Alabama LLC

  dba Breathing Care Associates - Panama City

  • Durable Medical Equipment & Medical Supplies
  • Panama City, FL
  • NPI 1740232982
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1912956590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 HONEYSUCKLE RD",
            "address_2": "STE C2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-794-6504",
            "fax_number": "334-793-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 HONEYSUCKLE RD",
            "address_2": "STE C2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-794-6504",
            "fax_number": "334-793-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIELSON",
        "first_name": "GLEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00012449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51523143",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000015369",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay S Fretts, PA-C
• Marie Fryer
• Full Spectrum ABA of Alabama LLC
• Lisa Barry Fuller
• Tracy Baugh Fussell, M.S., LPC
• Tony Downing Gabrielson, M.D.
• Galloway Dental Implants and Periodontics, P.C.
• Adrianna Akevia Galloway
• Pamela Galloway, RN, CLC, DOULA
• Patrick Brannon Galloway, DDS, MS

• Family Medicine Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.