Bryan C Glenn, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001703A Issued in IN

Practice address

535 Lincoln Way W
Mishawaka, IN 46544-1800

Phone

(574) 255-1716

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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 IN

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Family Chiropractic Center, PC

  • Chiropractor
  • Mishawaka, IN
  • NPI 1730209479
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1295721843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 LINCOLN WAY W",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441800",
            "telephone_number": "574-255-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 LINCOLN WAY W",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441800",
            "telephone_number": "574-255-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "BRYAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001703A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200119230A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000202168",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Gipson-Willis, LCSW
• Anthony William Gish, OD
• GKZ Partners Inc
• Jessica Grace Glassman, NP
• Glenn S. Wheet, MD, PC
• Lorrajean A Gleva
• Jessica A Gnoth
• Destinee Goble
• Imelda Godbold, RN
• Haley Goethals, MS

• Chiropractor in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.