Active NPI
John J Gleysteen, MD
- Surgery Physician
- Birmingham, AL
National Provider Identifier
1932144193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5505
- Practice address
- 619 19TH St S
Birmingham, AL 35249-1900 - Phone
- (205) 934-6600
- NPI assigned
- Jun 19, 2006
- Last updated
- Jan 17, 2008
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5505 | AL | Primary |
Addresses
Primary practice location
619 19TH St S
Birmingham, AL 35249-1900
Mailing address
PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C70731 | Other | AL | VIVA |
| MEDICARE | Other | AL | 00017488 |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5505 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1932144193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310",
"telephone_number": "205-731-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352491900",
"telephone_number": "205-934-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLEYSTEEN",
"first_name": "JOHN",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AL",
"license": "5505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "C70731",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "00017488",
"identifier": "MEDICARE",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.