Individual provider Active NPI

Thomas P. Glynn Jr., M.D.

  • Diagnostic Radiology Physician
  • Richmond, IN
National Provider Identifier
1003873795
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01028848 Issued in IN
Practice address
1100 Reid Pkwy
Richmond, IN 47374-1157
Phone
(765) 983-3000
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01028848 IN Primary

Addresses

Primary practice location

1100 Reid Pkwy
Richmond, IN 47374-1157

Mailing address

35 S 8TH St
Richmond, IN 47374-5441
Phone (765) 966-2929

Other identifiers 1

IdentifierTypeStateIssuer
100319730MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Radiologists, Inc. Diagnostic Radiology PastSince Jul 1, 1997 Accepting new patients
Reid Hospital & Health Care Services, Inc Diagnostic Radiology Past Accepting new patients
Universal Radiology Consultants PC Diagnostic Radiology PastSince Aug 12, 2017 Accepting new patients
Reid Hospital & Health Care Services Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1003873795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S 8TH ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473745441",
            "telephone_number": "765-966-2929",
            "fax_number": "765-966-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "THOMAS",
        "middle_name": "P.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01028848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100319730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.