Dale Beaird Glover, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

200155 Issued in LA

Practice address

1401 Foucher St FL 5
New Orleans, LA 70115-3515

Phone

(504) 897-7999

Fax

(504) 897-7676

NPI assigned

Aug 8, 2006

Last updated

Feb 28, 2019By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1972513364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CRESCENT CITY PHYSICIANS, INC.",
            "address_2": "3600 PRYTANIA ST., STE. 35",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153678",
            "telephone_number": "504-897-7197",
            "fax_number": "504-249-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FOUCHER ST FL 5",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153515",
            "telephone_number": "504-897-7999",
            "fax_number": "504-897-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Foucher St./Touro Infusion Center",
            "address_purpose": "LOCATION",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153515",
            "country_code": "US",
            "telephone_number": "504-897-8970",
            "fax_number": "504-897-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "DALE",
        "middle_name": "BEAIRD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04743",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "200155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2131991",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy A Glorioso, PA
• Jacqueline Marie Glorioso, LCSW
• John Glotfelty, PA
• Aaron Jeffrey Gloth, PMHNP
• Alaina Glover, LPC
• Dianna Michelle Glover, BSN, RN, FNP-S
• Dominique Jacquell Glover
• Leon Glover
• Liza Glover
• Raven Glover

• Medical Physician Assistant in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Medical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.