Individual provider Active NPI

Glenn Steven Pfitzner, MD

  • Gastroenterology Physician
  • Mount Airy, NC
National Provider Identifier
1992799969
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
9501055 Issued in NC
Practice address
951 Rockford St
Mount Airy, NC 27030-5323
Phone
(336) 719-7993
Fax
(336) 719-6550
NPI assigned
Sep 7, 2005
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 9501055 NC Primary

Addresses

Primary practice location

951 Rockford St
Mount Airy, NC 27030-5323

Mailing address

951 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7993

Other identifiers 1

IdentifierTypeStateIssuer
890201LMedicaidNC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9501055NCMDGastroenterology Physician

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1992799969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "27030",
            "telephone_number": "336-719-7993",
            "fax_number": "336-719-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305323",
            "telephone_number": "336-719-7993",
            "fax_number": "336-719-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFITZNER",
        "first_name": "GLENN",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9501055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890201L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.