Individual provider Active NPI

Glen D Hurlston, MD

  • Anesthesiology Physician
  • Leesville, LA
National Provider Identifier
1962579052
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
022284 Issued in LA
Practice address
1020 W Fertitta Blvd
Leesville, LA 71446-4649
Phone
(337) 475-9927
Fax
(337) 475-9989
NPI assigned
Nov 30, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 022284 LA Primary

Addresses

Primary practice location

1020 W Fertitta Blvd
Leesville, LA 71446-4649

Mailing address

PO Box 54346
New Orleans, LA 70154-4346
Phone (337) 475-9927

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101005000975 LA Practitioner - AnesthesiologyPractitioner - Pain Management 2365634680 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical Branch at Galveston, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glen D. Hurlston, M.D., ApmcGroup PAC ID 3779557541, 26 clinicians
Allegiance Hospital of Many, LLCGroup PAC ID 3274607551, 40 clinicians

Practice addresses (Care Compare)

1020 Fertitta Blvd
Leesville, LA 71446-4645

1020 W Fertita Blvd
Leesville, LA 71446-4645
Phone (337) 239-9041

240 Highland Dr
Many, LA 71449-3718
Phone (318) 256-7380

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
022284LAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegiance Hospital of Many,LLC CurrentSince Apr 3, 2021 Accepting new patients
Allegiance Hospital of Many, LLC CurrentSince Apr 3, 2021 Accepting new patients
CLHG-Ville Platte LLC Anesthesiology CurrentSince Nov 23, 2019 Accepting new patients
Glen D. Hurlston, M.D., Apmc Anesthesiology CurrentSince May 5, 1999 Accepting new patients
CLHG-Ville Platte LLC CurrentSince Nov 23, 2019 Accepting new patients
Allegiance Hospital of Many, LLC Current Accepting new patients
Allegiance Hospital of Many, LLC Past Accepting new patients

Locations

300 E McNeese St
Ste 3A
Lake Charles, LA 70605
Phone (318) 480-1117

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

12060 Texas Hwy
Many, LA 71449
Phone (318) 256-6044

12060 Texas Hwy
#3
Many, LA 71449
Phone (318) 256-9002

240 Highland Dr
Many, LA 71449
Phone (318) 256-5691

800 E Main St
Ville Platte, LA 70586
Phone (337) 363-5684

Interoperability endpoints

  • Direct secure messaging: brhghurls@yourcarecommunity.org

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962579052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54346",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701544346",
            "telephone_number": "337-475-9927",
            "fax_number": "337-475-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464649",
            "telephone_number": "337-475-9927",
            "fax_number": "337-475-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLSTON",
        "first_name": "GLEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "022284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.