Matthew Glenn, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501012527 Issued in MI

Practice address

5896 Dixie Hwy Ste B
Clarkston, MI 48346-4503

Phone

(248) 461-6674

Fax

(248) 461-6594

NPI assigned

Apr 2, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthquest Physical Therapy and Wellness Center LLC

  • Physical Therapy Clinic/Center
  • Troy, MI
  • NPI 1336344068

  Physical Therapist

  NPD (past)
• KRS of Clawson LLC

  • Physical Therapy Clinic/Center
  • Clawson, MI
  • NPI 1194840223
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1003089749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5896 DIXIE HWY STE B",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464503",
            "telephone_number": "248-461-6674",
            "fax_number": "248-461-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5896 DIXIE HWY STE B",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464503",
            "telephone_number": "248-461-6674",
            "fax_number": "248-461-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giesken Counseling Services LLC
• Heather Lynn Giguere, SLP
• Lisa Gilchrist
• Inayat Gill, DO
• Catherine Glaser, OTRL
• GNS Medical Supplies, Inc.
• David William Goldenbogen, D.P.T.
• Faina Goldin, PT
• Jessica Lee Golding, RDN
• Stacy E Golliff, MS, LPC, NCC

• Physical Therapist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.