Active NPI
Glenn W McLendon, CRNA
- Certified Registered Nurse Anesthetist
- Osage Beach, MO
National Provider Identifier
1093963159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2006004784
- Practice address
- 54 Hospital Dr
Osage Beach, MO 65065-3050 - Phone
- (573) 302-1661
- Fax
- (573) 302-1719
- NPI assigned
- Sep 3, 2008
- Last updated
- Sep 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2006004784 | MO | Primary |
Addresses
Primary practice location
54 Hospital Dr
Osage Beach, MO 65065-3050
Mailing address
PO Box 840
Osage Beach, MO 65065-0840
Phone (573) 302-1661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093963159 | Medicaid | MO |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake of the Ozarks Pain Management Services, Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Ozark Anesthesia Associates, Inc. | 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.
-
- Specialist
- Osage Beach, MO
- NPI 1003901976
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Springfield, MO
- NPI 1831109586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1093963159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650650840",
"telephone_number": "573-302-1661",
"fax_number": "573-302-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 HOSPITAL DR",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650653050",
"telephone_number": "573-302-1661",
"fax_number": "573-302-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLENDON",
"first_name": "GLENN",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-03",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2006004784",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093963159",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Osage Beach, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.