Organization Active NPI

Glenn Optical, PLLC

Doing business as Dr. Jason Glenn & Associates

  • Optometrist
  • Lexington, KY
National Provider Identifier
1245623362
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1685DT Issued in KY
Legal business name
GLENN OPTICAL, PLLC
Doing business as
Dr. Jason Glenn & Associates
Practice address
161 Lexington Green Cir
Suite B6
Lexington, KY 40503-3325
Phone
(859) 271-6194
Fax
(859) 271-4399
NPI assigned
Mar 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Authorized official

Name
Dr. Jason Glenn, O.D.NPI 1407995848
Title
Owner
Phone
(859) 271-6194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1685DT KY Primary

Addresses

Primary practice location

161 Lexington Green Cir
Suite B6
Lexington, KY 40503-3325

Mailing address

161 Lexington Green Cir
Suite B6
Lexington, KY 40503-3325
Phone (859) 271-6194

Other names 1

  • Dr. Jason Glenn & Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250925001553 KY Part B Supplier - Clinic/Group Practice 1759886229 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

116 Towne Center Dr
Lexington, KY 40511
Phone (859) 226-0303

Practitioners & affiliated clinicians

Practitioners 6

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": "1426204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1245623362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 LEXINGTON GREEN CIR",
            "address_2": "SUITE B6",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033325",
            "telephone_number": "859-271-6194",
            "fax_number": "859-271-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 LEXINGTON GREEN CIR",
            "address_2": "SUITE B6",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033325",
            "telephone_number": "859-271-6194",
            "fax_number": "859-271-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN OPTICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-271-6194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1685DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Jason Glenn & Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.