Individual provider Active NPI

Jolynn Marie Glanzer, M.D.

  • Family Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1063490654
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20230 Issued in IA
Practice address
411 10TH St SE
Suite 1400
Cedar Rapids, IA 52403-2467
Phone
(319) 365-8616
Fax
(319) 297-7377
NPI assigned
Jan 4, 2006
Last updated
Dec 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20230 IA Primary

Addresses

Primary practice location

411 10TH St SE
Suite 1400
Cedar Rapids, IA 52403-2467

Mailing address

411 10TH St SE
Suite 1400
Cedar Rapids, IA 52403-2467
Phone (319) 365-8616

Other identifiers 1

IdentifierTypeStateIssuer
0150417MedicaidIA

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

State licenses

LicenseStateTypeSpecialty
20230IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Nelson MD PC Family Medicine PastSince Mar 15, 2013 Accepting new patients
Glanzer & Nelson PC Family Medicine Past Accepting new patients

Organizations & group practices 2

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1063490654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 10TH ST SE",
            "address_2": "SUITE 1400",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032467",
            "telephone_number": "319-365-8616",
            "fax_number": "319-297-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 10TH ST SE",
            "address_2": "SUITE 1400",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032467",
            "telephone_number": "319-365-8616",
            "fax_number": "319-297-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANZER",
        "first_name": "JOLYNN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "20230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150417",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.