Individual provider Active NPI

Glenn Amandus Schiffler, M.D.

  • Family Medicine Physician
  • Plymouth, MN
National Provider Identifier
1174598924
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23362 Issued in MN
Practice address
9750 Rockford Rd
Plymouth, MN 55442-2893
Phone
(763) 235-5100
Fax
(763) 559-9404
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23362 MN Primary

Addresses

Primary practice location

9750 Rockford Rd
Plymouth, MN 55442-2893

Mailing address

9750 Rockford Rd
Plymouth, MN 55442-2893
Phone (763) 235-5100

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Camden Physicians LTD. Family Medicine Past Accepting new patients

Organizations & group practices 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1174598924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 ROCKFORD RD",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422893",
            "telephone_number": "763-235-5100",
            "fax_number": "763-559-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 ROCKFORD RD",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422893",
            "telephone_number": "763-235-5100",
            "fax_number": "763-559-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIFFLER",
        "first_name": "GLENN",
        "middle_name": "AMANDUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "23362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.