John Glenn

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1300 Braden St
Jacksonville, AR 72076-3719

Phone

(501) 743-6855

NPI assigned

Oct 13, 2015

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

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Group practices

Orthopedic Rehabilitation Centers LLCGroup PAC ID 3678560695, 10 clinicians

Premiere Physical Therapy and Sports Rehab LLCGroup PAC ID 9234236183, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Orthopedic Rehabilitation Centers LLC

  • Physical Therapist
  • Little Rock, AR
  • NPI 1780692491
  Medicare reassignment Care Compare group NPD
• Premiere Physical Therapy and Sports Rehab LLC

  • Physical Therapy Clinic/Center
  • Bentonville, AR
  • NPI 1134258981

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Farrer Physical Therapy Inc

  • Physical Therapist
  • Jacksonville, AR
  • NPI 1730550203
  NPD (past)

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1043681349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 LEWISBURG RD",
            "city": "AUSTIN",
            "state": "AR",
            "postal_code": "720079455",
            "telephone_number": "501-743-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763719",
            "telephone_number": "501-743-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara George
• Tiarra Gibbons
• Logan Gilbertson, OTR4172
• Mika Tamara Gill, LMSW
• April Glasgow, QBHP
• Isabella Noelle Gordon
• GPN Jacksonville LLC
• George Thompson Gray III, D.O.
• Gregory K. Bollen, DDS, P.a.
• Deana Grisham, LPN

• Physical Therapist in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.