Individual provider Active NPI

Glenn Labra Gandionco, RN

  • Registered Nurse
  • Huber Heights, OH
National Provider Identifier
1962655647
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN325343 Issued in OH
Practice address
7618 Mount Hood
Huber Heights, OH 45424-6918
Phone
(937) 235-0263
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN325343 OH Primary

Addresses

Primary practice location

7618 Mount Hood
Huber Heights, OH 45424-6918

Mailing address

7618 Mount Hood
Huber Heights, OH 45424-6918
Phone (937) 235-0263

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN325343OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1962655647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7618 MOUNT HOOD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454246918",
            "telephone_number": "937-235-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7618 MOUNT HOOD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454246918",
            "telephone_number": "937-235-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDIONCO",
        "first_name": "GLENN",
        "middle_name": "LABRA",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN325343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.