NPIMap

Organization Active NPI

Glenn S. Prescod, M.D., M.P.H., Inc.

  • Ophthalmology Physician
  • Pawtucket, RI
National Provider Identifier
1114271053
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
08767 Issued in RI
Legal business name
GLENN S. PRESCOD, M.D., M.P.H., INC.
Practice address
333 School St
Suite 301
Pawtucket, RI 02860-5334
Phone
(401) 725-3600
Fax
(401) 728-8760
NPI assigned
Oct 30, 2012
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. Glenn S. Prescod, M.D.NPI 1336263102
Title
Owner
Phone
(401) 725-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Ophthalmology Physician 207W00000X 08767 RI Primary

Addresses

Primary practice location

333 School St
Suite 301
Pawtucket, RI 02860-5334

Mailing address

333 School St
Suite 301
Pawtucket, RI 02860-5334
Phone (401) 725-3600

Other identifiers 1

IdentifierTypeStateIssuer
9020656MedicaidRI

National Provider Directory

National Provider Directory

Locations

333 School St
Ste 301
Pawtucket, RI 02860
Phone (401) 725-3600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1114271053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SCHOOL ST",
            "address_2": "SUITE 301",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605334",
            "telephone_number": "401-725-3600",
            "fax_number": "401-728-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SCHOOL ST",
            "address_2": "SUITE 301",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605334",
            "telephone_number": "401-725-3600",
            "fax_number": "401-728-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN S. PRESCOD, M.D., M.P.H., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "PRESCOD",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-725-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "08767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9020656",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.