Individual provider Active NPI

Anneliese K. Glasgow, FNP-BC

  • Family Nurse Practitioner
  • Wayne, PA
National Provider Identifier
1114531100
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61917 Issued in NM
Practice address
151 S Warner Rd Ste 100
Wayne, PA 19087-2127
Phone
(800) 301-0110
NPI assigned
Sep 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 61917 NM Primary

Addresses

Primary practice location

151 S Warner Rd Ste 100
Wayne, PA 19087-2127

Mailing address

PO Box 14263
Las Cruces, NM 88013-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260402000155 NM Practitioner - Nurse Practitioner 4880179357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2129 Osuna Rd NE
Albuquerque, NM 87113-1002

2129 Osuna Rd NE
Albuquerque, NM 87113-7001

PO Box
Suite 13624
Las Cruces, NM 88013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61917NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Primary Care Group P.C. PastSince Sep 10, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1114531100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14263",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880134263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S WARNER RD STE 100",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872127",
            "telephone_number": "800-301-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASGOW",
        "first_name": "ANNELIESE",
        "middle_name": "K.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "61917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

Verify at the official NPI Registry.