Organization Active NPI

Glennon Anderson LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
National Provider Identifier
1235893793
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
GLENNON ANDERSON LLC
Practice address
730 Beach Blvd Ste 101
Jacksonville, FL 32250-5352
Phone
(770) 286-4631
NPI assigned
Oct 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Authorized official

Name
Dr. Dr. Austin Glennon, DC
Title
Owner
Phone
(770) 286-4631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

730 Beach Blvd Ste 101
Jacksonville, FL 32250-5352

Mailing address

730 Beach Blvd Ste 101
Jacksonville Beach, FL 32250-5352
Phone (904) 246-1512

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1235893793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 BEACH BLVD STE 101",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505352",
            "telephone_number": "904-246-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 BEACH BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322505352",
            "telephone_number": "770-286-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENNON ANDERSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "GLENNON",
        "authorized_official_first_name": "DR. AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-286-4631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.