Individual provider Active NPI

Rose L Glynne, MD

  • Obstetrics & Gynecology Physician
  • Paragould, AR
National Provider Identifier
1093717035
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E-8911 Issued in AR
Practice address
1110 W Kingshighway
Paragould, AR 72450-4164
Phone
(870) 205-2000
Fax
(870) 205-2001
NPI assigned
Aug 10, 2005
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 36353 NC
Obstetrics & Gynecology Physician 207V00000X E-8911 AR Primary

Addresses

Primary practice location

1110 W Kingshighway
Paragould, AR 72450-4164

Mailing address

1000 W Kingshighway Ste 14
Paragould, AR 72450-4197
Phone (870) 239-8591

Other identifiers 3

IdentifierTypeStateIssuer
36353OtherNCLICENSE
206899001MedicaidAR
89013T3MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AR, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080312000125 NC Practitioner - Obstetrics/Gynecology 5698780021 Reassigns benefits to 1 organization
I20150204000262 AR Practitioner - Obstetrics/Gynecology 5698780021
I20250321002069 MO Practitioner - Obstetrics/Gynecology 5698780021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tufts University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

650 S Mount Auburn Rd
Suite 200
Cape Girardeau, MO 63703-4941
Phone (573) 339-1101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-8911ARMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC Obstetrics & Gynecology CurrentSince Mar 12, 2025 Accepting new patients
Paragould Obstetrics and Gynecology, PLLC Past Accepting new patients
Southeast Hospital Past Accepting new patients
Eastern Carolina Ear, Nose & Throat-Head & Neck Surgery, Inc PastSince Aug 3, 2009 Accepting new patients

Locations

650 S Mount Auburn Rd
Ste 200
Cape Girardeau, MO 63703
Phone (573) 339-1101

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

Interoperability endpoints

  • Direct secure messaging: rose.glynne@ammcps.eclinicaldirectplus.com

Organizations & group practices 5

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 1

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1093717035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W KINGSHIGHWAY STE 14",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504197",
            "telephone_number": "870-239-8591",
            "fax_number": "870-239-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504164",
            "telephone_number": "870-205-2000",
            "fax_number": "870-205-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNNE",
        "first_name": "ROSE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "36353",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E-8911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "36353",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206899001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013T3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.