Glen Loy Portwood, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

9300570 Issued in NC

Practice address

101 E WT Harris Blvd Ste 3111
Charlotte, NC 28262-7002

Phone

(704) 547-8818

Fax

(704) 547-9865

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, NV, SC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Internal Medicine

Education

Medical College of Georgia School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Digestive Health Associates PAGroup PAC ID 1951209790, 45 clinicians

Collins Carson City Gastroenterology, LTDGroup PAC ID 8022474329, 12 clinicians

DLP Frye Medical Group LLCGroup PAC ID 8123397601, 125 clinicians

Georgetown Physician Associates, LLCGroup PAC ID 2365697398, 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Frye Regional Medical Center Hospital, Hickory, NC, CCN 340116
• Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
• Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Carolina Digestive Health Associates, PA

  • Gastroenterology Physician
  • Charlotte, NC
  • NPI 1124052444
  Medicare reassignment Care Compare group NPD
• DLP Frye Medical Group LLC

  • Rural Health Clinic/Center
  • Lincolnton, NC
  • NPI 1154005965
  Medicare reassignment Care Compare group NPD
• Collins Carson City Gastroenterology LTD

  • Gastroenterology Physician
  • Carson City, NV
  • NPI 1780395764
  Medicare reassignment Care Compare group NPD
• Georgetown Physician Associates, LLC

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1235475930
  Medicare reassignment Care Compare group
• DLP Frye Medical Group, LLC

  • Family Medicine Physician
  • Hickory, NC
  • NPI 1821537697

  Gastroenterology

  NPD
• Georgetown Physician Associates

  • Gastroenterology Physician
  • Georgetown, SC
  • NPI 1093139420
  NPD
• Georgetown Physician Associates LLC

  • Family Medicine Physician
  • Georgetown, SC
  • NPI 1881410587
  NPD
• Carolina Digestive Health Associates, PA

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1063584415
  NPD (past)

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

• DLP Frye Regional Medical Center LLC

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1801823349
  Care Compare affiliation
• Georgetown Memorial Hospital

  • Skilled Nursing Facility
  • Georgetown, SC
  • NPI 1881307056

  Hospital

  Care Compare affiliation
• Georgetown Memorial Hospital

  • General Acute Care Hospital
  • Georgetown, SC
  • NPI 1982604021
  Care Compare affiliation
• Waccamaw Community Hospital

  • General Acute Care Hospital
  • Murrells Inlet, SC
  • NPI 1972503910
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1316965726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 CARMEL COMMONS BLVD",
            "address_2": "STE 302",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265305",
            "telephone_number": "704-372-7974",
            "fax_number": "704-372-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WT HARRIS BLVD STE 3111",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282627002",
            "telephone_number": "704-547-8818",
            "fax_number": "704-547-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTWOOD",
        "first_name": "GLEN",
        "middle_name": "LOY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9300570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901259",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McCaryn Porter, BCBA
• Robert Edwin Porter, DDS
• William Edward Porter, MD
• Stepfon Teonta Portlock, LCSW
• Hailey Portmann, OTR/L
• Chelsea N Poser, PA-C
• Stephanie Posey-Armstrong
• Ashley Dianne Posey, LPCA, NCC
• Austyn Marie Posey, PHARMD
• Ruth Elaine Posey, CRNA

• Gastroenterology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Gastroenterology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.