Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Leah Glick, PAC

Individual provider Physician Assistant · NPI 1578817466

Kelly Leah Glick, PAC is a Physician Assistant in Dickinson, North Dakota. Qualified in 2012, 14 years ago. Practices with Omaha Therapy Inc, a 69-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
14
Licensed in
ND
In the registry since
2012
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2500 Fairway St
Dickinson, ND 58601-2639
Phone: (701) 456-4200
Fax: (701) 456-4545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PAC0507 (ND)

Record details

NPI number1578817466
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 31, 2012
Last updated in NPPESMarch 15, 2017

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Omaha Therapy Inc — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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