Joseph R Glennon III, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2169 Issued in MA

Practice address

1212 Kempton St
New Bedford, MA 02740-1503

Phone

(508) 997-3222

Fax

(508) 997-6848

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1225145014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 KEMPTON ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027401503",
            "telephone_number": "508-997-3222",
            "fax_number": "508-997-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 KEMPTON ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027401503",
            "telephone_number": "508-997-3222",
            "fax_number": "508-997-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0318515",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SDMEA",
            "identifier": "0481020001",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly E Gilman, LICSW
• Kelly W Gin
• Rachel Gin, FNP-C
• Dwayne Glenn
• Brandon Edward Glennon, PHARM D
• Global Learning Charter Public School
• Denise Gluchacki, COTA/L
• Heather Goddard, MD
• Joan Godding, CAC, LADCI
• Mary Katherine Goldberg, RD, MPG, LDN

• Optometrist in New Bedford, MA
• Providers in New Bedford, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.