Active NPI
Kylin Glasscoe
- Rehabilitation Practitioner
- Lansing, MI
National Provider Identifier
1164870838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- G 420 485 367 881
- Practice address
- 1741 Springfield LN
Lansing, MI 48912-4533 - Phone
- (517) 214-3907
- NPI assigned
- Jun 2, 2016
- Last updated
- Jun 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | G 420 485 367 881 | MI | Primary |
Addresses
Primary practice location
1741 Springfield LN
Lansing, MI 48912-4533
Mailing address
1741 Springfield LN
Lansing, MI 48912-4533
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
| License | State | Type | Specialty |
|---|---|---|---|
| G 420 485 367 881 | MI | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1164870838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1741 SPRINGFIELD LN",
"city": "LANSING",
"state": "MI",
"postal_code": "489124533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1741 SPRINGFIELD LN",
"city": "LANSING",
"state": "MI",
"postal_code": "489124533",
"telephone_number": "517-214-3907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSCOE",
"first_name": "KYLIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-02",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "MI",
"license": "G 420 485 367 881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.