Glen Sheridan Clinton, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

15844A Issued in WY

Practice address

981150 Nebraska Medical Center Omaha NE 68198-1150
Omaha, NE 68198-0001

Phone

(402) 559-6802

NPI assigned

Jun 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Washington School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group LLCGroup PAC ID 5092094532, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014
• Ivinson Memorial Hospital Hospital, Laramie, WY, CCN 530025
• Powell Valley Hospital Hospital, Powell, WY, CCN 531310
• Cody Regional Health Hospital, Cody, WY, CCN 531312

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Summit Medical Group, LLC

  • Emergency Medicine Physician
  • Cheyenne, WY
  • NPI 1457802993
  Medicare reassignment Care Compare group NPD
• Powell Valley Health Care Inc

  • Critical Access Hospital
  • Powell, WY
  • NPI 1497753115
  Medicare reassignment NPD
• Powell Valley Healthcare Inc

  • Family Medicine Physician
  • Powell, WY
  • NPI 1699721316

  Emergency Medicine

  Medicare reassignment NPD
• West Park Hospital District

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Medicare reassignment NPD
• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197
  NPD
• West Park Hospital District

  • Emergency Medicine Physician
  • Basin, WY
  • NPI 1942921937
  NPD
• Unmc

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1962625772
  NPD (past)
• West Park Hospital District

  • Multi-Specialty Clinic/Center
  • Cody, WY
  • NPI 1477192243
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197

  Hospital

  Care Compare affiliation
• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1336289552
  Care Compare affiliation
• Memorial Hospital of Laramie County

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Care Compare affiliation
• Powell Valley Health Care Inc

  • Critical Access Hospital
  • Powell, WY
  • NPI 1497753115
  Care Compare affiliation
• West Park Hospital District

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Care Compare affiliation

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1043836992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981150 NEBRASKA MEDICAL CENTER OMAHA NE 68198-1150",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981150 NEBRASKA MEDICAL CENTER OMAHA NE 68198-1150",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-559-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "GLEN",
        "middle_name": "SHERIDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "15844A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Cline
• Kirsten Cline
• Samantha Marie Cline
• Sara Cline
• Clinica Medica Vida Plus, LLC
• Rebecca Clipperton
• Clocktower Chiropractic, Inc
• Christian Clodfelder, DO
• Esther Cloeter
• Alanna Clontz

• Emergency Medicine Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Emergency Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.