Individual provider Active NPI

John Randolph Glynn, MSW

  • Clinical Social Worker
  • Nashville, TN
National Provider Identifier
1114033503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6252 Issued in TN
Practice address
1310 24TH Ave S
Nashville, TN 37212-2637
Phone
(615) 327-4751
Fax
(615) 321-6350
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6252 TN Primary

Addresses

Primary practice location

1310 24TH Ave S
Nashville, TN 37212-2637

Mailing address

3114 Overhill CT
Murfreesboro, TN 37130-1392

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
6252TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114033503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 OVERHILL CT",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371301392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "615-327-4751",
            "fax_number": "615-321-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "JOHN",
        "middle_name": "RANDOLPH",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.