Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Charles C Glass, PA-C

Individual provider Physician Assistant · NPI 1003219304

Charles C Glass, PA-C is a Physician Assistant in Leavenworth, Kansas. Qualified in 2014, 12 years ago. Practices with Kansas Medical Clinic PA, a 51-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kansas and Missouri.

Years since qualifying
12
Licensed in
KS, MO
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3550 S 4th St Ste 250
Leavenworth, KS 66048-5061
Phone: (913) 565-2569
Fax: (913) 565-2571
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3511 Clinton Pl Ste C, Lawrence, KS 66047-2213 — (785) 331-4488

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15-01742 (KS)
Physician Assistant Taxonomy 363A00000X · Licence 2015022139 (MO)

Record details

NPI number1003219304
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 30, 2014
Last updated in NPPESJuly 8, 2021
Certification dateJuly 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Kansas Medical Clinic Pa — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Leavenworth