Individual provider Active NPI

Mary Gleason, MARY GLEASON, FNP-BC

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1992035174
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN1006509 Issued in DC
Practice address
5255 Loughboro Rd NW
Sibley Memorial Hospital - Pain Center
Washington, DC 20016-2633
Phone
(202) 537-4589
NPI assigned
Jan 11, 2010
Last updated
Jan 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC000760 MD
Family Nurse Practitioner 363LF0000X RN1006509 DC Primary
Registered Nurse 163W00000X RN1006509 DC
Registered Nurse 163W00000X 0001209828 VA
Oncology Registered Nurse 163WX0200X AC000760 MD

Addresses

Primary practice location

5255 Loughboro Rd NW
Sibley Memorial Hospital - Pain Center
Washington, DC 20016-2633

Mailing address

5255 Loughboro Rd NW
Sibley Memorial Hospital - Pain Center
Washington, DC 20016-2633
Phone (202) 537-4589

Other identifiers 1

IdentifierTypeStateIssuer
036182800MedicaidMD

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001209828VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1992035174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 LOUGHBORO RD NW",
            "address_2": "SIBLEY MEMORIAL HOSPITAL - PAIN CENTER",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162633",
            "telephone_number": "202-537-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 LOUGHBORO RD NW",
            "address_2": "SIBLEY MEMORIAL HOSPITAL - PAIN CENTER",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162633",
            "telephone_number": "202-537-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "MARY",
        "credential": "MARY GLEASON, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC000760",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1006509",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1006509",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001209828",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "MD",
            "license": "AC000760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036182800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.