Glen Deitrick, CRNA - Nurse Anesthetist, Certified Registered in Gulfport, MS

Glen Deitrick, CRNA is a Nurse Anesthetist, Certified Registered based in Gulfport, Mississippi. Glen Deitrick is licensed to practice in Mississippi (license number R128610) and his current practice location is 15190 Community Rd, Suite 230a, Gulfport, Mississippi. He can be reached at his office (for appointments etc.) via phone at (228) 831-0204.

NPI number for Glen Deitrick is 1033214564 and his current mailing address is 15190 Community Rd, Suite 230a, Gulfport, Mississippi. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1033214564.

Contact Information

Glen Deitrick, CRNA
15190 Community Rd, Suite 230a,
Gulfport, MS 39503-3485
(228) 831-0204
(228) 831-1868

Map and Direction




Provider's Profile

Full NameGlen Deitrick
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location15190 Community Rd, Gulfport, Mississippi
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1033214564
  • Provider Enumeration Date: 09/13/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Glen Deitrick such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033214564NPI-NPPES
00111157MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered R128610 (Mississippi)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glen Deitrick is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Glen Deitrick, CRNA
15190 Community Rd, Suite 230a,
Gulfport, MS 39503-3485

Ph: (228) 831-0204
Glen Deitrick, CRNA
15190 Community Rd, Suite 230a,
Gulfport, MS 39503-3485

Ph: (228) 831-0204

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Gulfport, MS

Kathryn Pittman, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 15200 Community Rd, Gulfport, MS 39503
Phone: 228-575-7000    
Jason Wells, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4500 13th St, Gulfport, MS 39501
Phone: 228-865-3281    Fax: 228-867-5117
Victor P Polito, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 15190 Community Rd, Suite 230a, Gulfport, MS 39503
Phone: 228-831-0204    Fax: 228-831-1868
Glen Michael Cavalier, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 15200 Community Rd, Gulfport, MS 39503
Phone: 228-575-7000    
Julie K Klester, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 15190 Community Rd, Suite 230a, Gulfport, MS 39503
Phone: 228-831-0204    Fax: 228-831-1868
Trinh Thu Weatherly, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4500 13th St, Gulfport, MS 39501
Phone: 228-867-4000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.