Dawn Marie Glaze, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

04171 Issued in OH

Practice address

1036 S Perry St
Napoleon, OH 43545-2159

Phone

(419) 592-1688

NPI assigned

Sep 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Dawn Marie Laytart Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1992477798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9390 STATE ROUTE 12",
            "city": "COLUMBUS GROVE",
            "state": "OH",
            "postal_code": "458309609",
            "telephone_number": "419-203-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 S PERRY ST",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435452159",
            "telephone_number": "419-592-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZE",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "04171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9390 State Route 12",
            "city": "Columbus Grove",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458309609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "LAYTART",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Elizabeth Ghast, LPN
• Christy Markley Ghaster, MSSA, LSW
• Dawn R Gillen, LPN
• Sarah Lynn Gioiella, MS, QMHS, CMS
• Kayla Marie Giovarelli, RDH
• Andrew Carrington Gombash, D.O.
• Sandra Gomez, LPN
• Chillim Gonzales, COTA/L
• Jeffery Gonzales, QMHS
• Kourtney Gossard

• Physical Therapy Assistant in Napoleon, OH
• Providers in Napoleon, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.