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  7. NPI Record 1063457653

RANDALL N GLASER P.A.
Complete NPI Record 1063457653
Physician Assistant in Billings, MT

NPI Status: Active since June 18, 2006

Contact Information

2900 12TH AVE N STE 140W
BILLINGS, MT
ZIP 59101
Phone: (406) 237-5050
Fax: (406) 238-6599

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Provider Gender Code
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Other Provider Identifier 1
  29. Other Provider Identifier Type Code 1
  30. Other Provider Identifier State 1
  31. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1063457653. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1063457653
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Entity Type Code: 1
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider First Name: RANDALL
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Middle Name: N
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Credential Text: P.A.
The city name in the location address of the provider being identified.
Provider First Line Business Mailing Address: 2900 12TH AVE N STE 140W
The State code in the location of the provider being identified.
Provider Business Mailing Address City Name: BILLINGS
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address State Name: MT
The country code in the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 591017507
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Telephone Number: 4062375050
The date that a record was last updated or changed.
Provider Business Mailing Address Fax Number: 4062386599
The code designating the provider’s gender if the provider is a person.
Provider First Line Business Practice Location Address: 2900 12TH AVE N STE 140W
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address City Name: BILLINGS
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address State Name: MT
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Practice Location Address Postal Code: 591017507
The State code in the location of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 4062375050
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 4062386599
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/18/2006
The last name of the provider. If the provider is an individual, this is the legal name.
Last Update Date: 1/4/2011
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 363A00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 321
Other last name by which the provider being identified is or has been known.
Provider License Number State Code 1: MT
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 0439705
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: MT
Is Sole Proprietor: N
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.