Individual provider Active NPI

Glenn Allen Hadlock, DC

  • Chiropractor
  • Sarasota, FL
National Provider Identifier
1942300306
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8415 Issued in FL
Practice address
7425 N Tamiami Trail
Sarasota, FL 34243
Phone
(941) 351-3466
Fax
(941) 351-3639
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8415 FL Primary

Addresses

Primary practice location

7425 N Tamiami Trail
Sarasota, FL 34243

Mailing address

7425 N Tamiami Trail
Sarasota, FL 34243
Phone (941) 351-3466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050401000108 FL Practitioner - Chiropractic 7810944980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5664 Bee Ridge Rd
Suite 102
Sarasota, FL 34233-1504
Phone (941) 925-1517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8415FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn a. Hadlock, D.C., Inc. CurrentSince Jun 1, 2009 Accepting new patients
Edward J. Fliss, Jr., PA Chiropractor PastSince Jan 3, 2005 Accepting new patients

Locations

5664 Bee Ridge Rd
Ste 102
Sarasota, FL 34233
Phone (941) 377-4594

Organizations & group practices 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942300306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 N TAMIAMI TRAIL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34243",
            "telephone_number": "941-351-3466",
            "fax_number": "941-351-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 N TAMIAMI TRAIL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34243",
            "telephone_number": "941-351-3466",
            "fax_number": "941-351-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLOCK",
        "first_name": "GLENN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.