Individual provider Active NPI

Glenda Gean Anderson

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1104394774
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
453389 Issued in OH
Practice address
1301 N High St
Columbus, OH 43201-2460
Phone
(614) 299-6600
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 453389 OH Primary

Addresses

Primary practice location

1301 N High St
Columbus, OH 43201-2460

Mailing address

1791 Alum Creek Dr
Columbus, OH 43207-1757
Phone (614) 445-8131

Other practice location 1

2906 Wambli Dr
Columbus, OH 43219-3285
Phone (614) 928-0752

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

State licenses

LicenseStateTypeSpecialty
453389OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Mental Health Current Accepting new patients

Locations

1301 N High St
Columbus, OH 43201
Phone (614) 299-6600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1104394774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 ALUM CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432071757",
            "telephone_number": "614-445-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012460",
            "telephone_number": "614-299-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 Wambli Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432193285",
            "country_code": "US",
            "telephone_number": "614-928-0752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GLENDA",
        "middle_name": "GEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "453389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.