Active NPI
Glenna Pember, PA
- Physician Assistant
- Arvada, CO
National Provider Identifier
1215967435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 722
- Practice address
- 7950 Kipling St
Ste 101
Arvada, CO 80005-3923 - Phone
- (303) 425-4680
- Fax
- (303) 425-1616
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 722 | CO | Primary |
Addresses
Primary practice location
7950 Kipling St
Ste 101
Arvada, CO 80005-3923
Mailing address
1707 Cole Blvd
Ste 100
Golden, CO 80401-3220
Phone (303) 716-8013
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 722 | CO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1215967435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1707 COLE BLVD",
"address_2": "STE 100",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804013220",
"telephone_number": "303-716-8013",
"fax_number": "303-763-5495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7950 KIPLING ST",
"address_2": "STE 101",
"city": "ARVADA",
"state": "CO",
"postal_code": "800053923",
"telephone_number": "303-425-4680",
"fax_number": "303-425-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEMBER",
"first_name": "GLENNA",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arvada, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.