Courtney Glenn DPM LLC
Organization Active NPI Podiatric Clinic/Center · Braselton, GA
NPI 1306221106 · NPPES record last updated Dec 29, 2025
Key facts
- NPI
- 1306221106
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatric Clinic/Center 261QP1100X
- License
- POD001277 (GA)
- Legal business name
- COURTNEY GLENN DPM LLC
- Practice address
- 1515 River PL Ste 370
Braselton, GA 30517-5605 - Phone
- (770) 648-5040
- Fax
- (706) 780-5366
- NPI assigned
- Jul 22, 2015
- Organization subpart
- No
Authorized official
- Name
- Courtney Glenn, DPM
- Title
- Owner
- Phone
- (814) 758-8425
Practitioners 2
-
Gemma P English, DPM
-
Courtney Lynn Glenn, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151027001571 | GA | Part B Supplier - Clinic/Group Practice | 8820307150 |
Receives reassigned benefits from 2 practitioners Practice locations: Braselton, GA |
| O20160630001574 | GA | DME Supplier - Physician - Podiatry | 8820307150 | Practice locations: Braselton, GA |
National Provider Directory
Locations
1515 River Pl
Ste 370
Braselton, GA 30517
Phone (770) 533-4770
578 S Enota Dr NE
Ste 4
Gainesville, GA 30501
Phone (770) 648-5040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | POD001277 | GA | Yes |
Addresses
Primary practice location
1515 River PL Ste 370
Braselton, GA 30517-5605
Mailing address
1515 River PL Ste 370
Braselton, GA 30517-5605
Phone (770) 648-5040
Other practice location 1
1500 Oglethorpe Ave Ste 500B
Athens, GA 30606-2184
Phone (770) 648-5040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831454750 | Other | PERSONAL NPI NUMBER |
Other providers in Braselton, GA
- David Cooney
- Jennifer Copper
- Ashley Corbett
- Cornerstone Surgery of Braselton, PC
- Marisol Paz Coughlin
- Emily Crampton
- Hasco William Craver III
- Lya Crichlow
- Crossroads Chiropractic
- Crossroads Spine & Wellness,LLC
All providers in Braselton, GA · Podiatric Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.