Active NPI
Glenda King
- Nurse Practitioner
- Rochester, NY
National Provider Identifier
1235615832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 308760
- Practice address
- 1455 E Ridge Rd
Rochester, NY 14621-2006 - Phone
- (585) 922-4882
- Fax
- (585) 922-4936
- NPI assigned
- Jul 17, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 308760 | NY | Primary |
Addresses
Primary practice location
1455 E Ridge Rd
Rochester, NY 14621-2006
Mailing address
100 Kings Hwy S
Rochester, NY 14617-5504
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549929600000",
"number": "1235615832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KINGS HWY S",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146175504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 E RIDGE RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146212006",
"telephone_number": "585-922-4882",
"fax_number": "585-922-4936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "GLENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-17",
"last_updated": "2019-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "308760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.