Glenn Robert Anderson, BS

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

9811 W Charleston Blvd Ste 2-2641
Las Vegas, NV 89117-7528

Phone

(855) 864-4322

NPI assigned

May 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1215629993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 LAKE AVE",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301914",
            "telephone_number": "906-281-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD STE 2-2641",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528",
            "telephone_number": "855-864-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GLENN",
        "middle_name": "ROBERT",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Lynn Anderson, NBC-HWC
• Erin Leigh Anderson
• Frank Anderson
• Frank L Anderson, DO
• Gabrielle Anderson
• Gwendolyn Surah Anderson
• Herlinda Anderson
• Hester Anderson
• James Anderson
• Jamie Anderson

• Electroneurodiagnostic Specialist/Technologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Electroneurodiagnostic Specialist/Technologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.