NPIMap

Individual provider Active NPI

Leanne C Glidewell, APN

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1073852877
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A003820 Issued in AR
Practice address
16221 Saint Vincent Way
Little Rock, AR 72223-9072
Phone
(501) 552-8150
Fax
(501) 552-8199
NPI assigned
Feb 14, 2013
Last updated
Dec 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A003820 AR Primary

Addresses

Primary practice location

16221 Saint Vincent Way
Little Rock, AR 72223-9072

Mailing address

16221 Saint Vincent Way
Little Rock, AR 72223-9072
Phone (501) 552-8150

Other practice location 1

600 S Timberlane Dr
El Dorado, AR 71730-6990
Phone (870) 862-2400

Other identifiers 1

IdentifierTypeStateIssuer
A003820OtherARSTATE APN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141007002529 AR Practitioner - Nurse Practitioner 7911127329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians
St. Vincent Physician Clinics LLCGroup PAC ID 5395975379, 9 clinicians

Practice addresses (Care Compare)

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

10301 Kanis Rd
Suite 1
Little Rock, AR 72205-6205
Phone (501) 562-4838

16221 Saint Vincent Way
Little Rock, AR 72223-9072
Phone (501) 552-8150

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A003820ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Jun 4, 2020 Accepting new patients
St Vincent Physician Clinics LLC Family CurrentSince Dec 20, 2017 Accepting new patients
Renew You Aesthetics & Wellness Family Current Accepting new patients

Locations

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

Interoperability endpoints

  • Direct secure messaging: leanne.glidewell@svmgs.eclinicaldirectplus.com
  • Direct secure messaging: lglidewell456690@direct.stlukeshealth.org

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1073852877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16221 SAINT VINCENT WAY",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239072",
            "telephone_number": "501-552-8150",
            "fax_number": "501-552-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16221 SAINT VINCENT WAY",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239072",
            "telephone_number": "501-552-8150",
            "fax_number": "501-552-8199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Timberlane Dr",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "AR",
            "postal_code": "717306990",
            "country_code": "US",
            "telephone_number": "870-862-2400",
            "fax_number": "870-962-1891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLIDEWELL",
        "first_name": "LEANNE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE APN LICENSE",
            "identifier": "A003820",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.