Individual provider Active NPI

Alexandra Glenn

  • Student in an Organized Health Care Education/Training Program
  • Morrisville, NC
National Provider Identifier
1124535075
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
413 Ruby Walk Dr
Morrisville, NC 27560-6740
Phone
(919) 445-6985
NPI assigned
Jan 1, 2018
Reactivated
Mar 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Athletic Trainer 2255A2300X

Addresses

Primary practice location

413 Ruby Walk Dr
Morrisville, NC 27560-6740

Mailing address

2000 Old Clinic
CB #7510
Chapel Hill, NC 27599-0001
Phone (919) 445-6985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609002076 FL Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 0143730192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1514764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1124535075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OLD CLINIC",
            "address_2": "CB #7510",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001",
            "telephone_number": "919-445-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 RUBY WALK DR",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275606740",
            "telephone_number": "919-445-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-01",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "deactivation_date": "2025-03-24",
        "reactivation_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

Verify at the official NPI Registry.