NPIMap

Individual provider Active NPI

Glen Ware Jr.

  • Family Nurse Practitioner
  • Kings Mountain, KY
National Provider Identifier
1306314752
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012813 Issued in KY
Practice address
24 Old South Fork Rd
Kings Mountain, KY 40442-9702
Phone
(606) 448-0693
NPI assigned
Nov 4, 2018
Last updated
Apr 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3012813 KY Primary

Addresses

Primary practice location

24 Old South Fork Rd
Kings Mountain, KY 40442-9702

Mailing address

24 Old South Fork Rd
Kings Mountain, KY 40442-9702
Phone (606) 448-0693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190225001757 KY Practitioner - Nurse Practitioner 4082953716 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Emhfl IncGroup PAC ID 7416842364, shared by 8 NPIs, 12 clinicians

Practice addresses (Care Compare)

109 Daniel Dr
Danville, KY 40422-2527
Phone (859) 236-3361

110 Metker TRL
Stanford, KY 40484-1020
Phone (606) 365-4600

120 Daniel Dr
Danville, KY 40422-2527
Phone (859) 239-5570

124 Daniel Dr
Danville, KY 40422-2527
Phone (859) 239-5570

125 Portman Ave
Stanford, KY 40484-1229
Phone (606) 365-3378

130 Daniel Dr
Danville, KY 40422-2527
Phone (859) 236-2222

217 S 3Rd St
Danville, KY 40422-1823
Phone (859) 239-2318

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.66 of 100Reported as group
Quality
39.23
Promoting interoperability
99
Improvement activities
40
Cost
43.79

Merit-based Incentive Payment System (MIPS)

Final score
81.36 of 100Reported as group
Quality
64.78
Promoting interoperability
100
Improvement activities
40
Cost
67.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc Family CurrentSince Jan 1, 2020 Accepting new patients
Ephraim McDowell Regional Medical Center Incorporated CurrentSince Jul 26, 2019 Accepting new patients
Ephraim McDowell Health Resource, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Ephraim McDowell Health Resource, Inc. Family Current Accepting new patients
The James B. Haggin Memorial Hospital Inc CurrentSince Oct 1, 2019 Accepting new patients
The James B. Haggin Memorial Hospital Inc CurrentSince Oct 1, 2019 Accepting new patients
Nick Dedman, MD and Associates, P.S.C. Family Current Accepting new patients
The James B. Haggin Memorial Hospital Inc Current Accepting new patients
Ephraim McDowell Health Resource, Inc Family Current Accepting new patients
Ephraim McDowell Regional Medical Center, Incorporated CurrentSince Jul 26, 2019 Accepting new patients
Ephraim McDowell Health Resource, Inc. Past Accepting new patients

Locations

109 Daniel Dr
Danville, KY 40422
Phone (859) 236-3361

1541 Lebanon Rd
Ste 1
Danville, KY 40422
Phone (859) 236-3208

216 W Walnut St
Ste A
Danville, KY 40422
Phone (859) 239-5870

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

464 Linden Ave
Harrodsburg, KY 40330
Phone (859) 734-5441

466 Linden Ave
#A
Harrodsburg, KY 40330
Phone (859) 734-5173

511 Middleburg St
Liberty, KY 42539
Phone (606) 236-2388

110 Metker Trl
Stanford, KY 40484
Phone (606) 365-3360

125 Portman Ave
Stanford, KY 40484
Phone (606) 365-3378

5130 Parkway Plaza Blvd
Charlotte, NC 28217

Organizations & group practices 12

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

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1541289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1306314752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 OLD SOUTH FORK RD",
            "city": "KINGS MOUNTAIN",
            "state": "KY",
            "postal_code": "404429702",
            "telephone_number": "606-448-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 OLD SOUTH FORK RD",
            "city": "KINGS MOUNTAIN",
            "state": "KY",
            "postal_code": "404429702",
            "telephone_number": "606-448-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARE",
        "first_name": "GLEN",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-04",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, KY

Sources for this page

Verify at the official NPI Registry.