Individual provider Active NPI

Alina N Glazunova, CRNP

  • Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1013384718
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015294 Issued in PA
Practice address
283 S Butler Rd
Lebanon, PA 17042-8939
Phone
(717) 273-8871
Fax
(717) 270-2452
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP015294 PA
Nurse Practitioner 363L00000X SP015294 PA Primary

Addresses

Primary practice location

283 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

785 5TH Ave Ste 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other identifiers 3

IdentifierTypeStateIssuer
103065790MedicaidPA
SP024636OtherPASTATE LICENSE
13623751OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023001066 PA Practitioner - Nurse Practitioner 1456660943 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP015294PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven CurrentSince Oct 24, 2016 Accepting new patients
Philhaven Current Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

785 5th Ave
Ste 3
Chambersburg, PA 17201

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

283 S Butler Rd
Lebanon, PA 17042

204 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-9777

283 Butler Rd
Mount Gretna, PA 17064
Phone (800) 932-0359

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1013384718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-709-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZUNOVA",
        "first_name": "ALINA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP015294",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103065790",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SP024636",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13623751",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.