GLENDA M UPDYKE (NPI# 1174582597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174582597 |
| Entity Type | Individual |
| Full Name | GLENDA M UPDYKE |
| Credential | MS PA-C |
| Practice Address |
3700 Southern Blvd Ste 201 Kettering OH 45429-1265 |
| Mailing Address |
1 Prestige Pl Ste 550 Miamisburg OH 45342-6115 |
| Practice Telephone | 8555002873 |
| Practice Fax Number | 9372813913 |
| Mailing Telephone | 9377621310 |
| Mailing Fax Number | 9375228068 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50.001269 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
50001269 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0085241 | 05 |
| Street Address |
3700 SOUTHERN BLVD STE 201 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598927824 | Nickolay Peter Markov | Plastic Surgery | 3700 Southern Blvd Ste 201, Kettering, OH 45429-1226 | 2008-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811532450 | Emily Rae Alverson | Physician Assistant | 500 Lincoln Park Blvd Ste 100, Kettering, OH 45429-6410 | 2019-11-07 |
| 1720459605 | Maria Elizabeth Buchanan | Physician Assistant | 3533 Southern Blvd Ste 2250, Kettering, OH 45429-1270 | 2015-10-17 |
| 1740578590 | Urooj Mujtaba | Physician Assistant | 4750 Hempstead Station Drive, Kettering, OH 45429 | 2011-07-14 |
| 1063410538 | David Evans | Physician Assistant | 3700 Southern Blvd Ste 300, Kettering, OH 45429-1226 | 2005-07-08 |
| 1922615954 | Kristen Maree Morrison | Physician Assistant | 500 Lincoln Park Blvd Ste 100, Kettering, OH 45429-6410 | 2020-09-24 |
| 1114534161 | Katherine Rachel Simpson | Physician Assistant | 500 Lincoln Park Blvd Ste 100, Kettering, OH 45429-6410 | 2020-09-24 |
| 1881208346 | Alexander John Armstrong | Physician Assistant | 3533 Southern Blvd, Kettering, OH 45429-1264 | 2020-09-02 |
| 1396360434 | Juliane Mckay | Physician Assistant | 999 Brubaker Dr, Kettering, OH 45429-3505 | 2020-06-15 |
| 1346891462 | Kellie Niehaus | Physician Assistant | 3533 Southern Blvd Ste 2100, Kettering, OH 45429-1267 | 2019-09-20 |
| 1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
| Find all providers in KETTERING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.