NPIMap

Individual provider Active NPI

Wendell Glover, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Ridgeland, MS
National Provider Identifier
1336535053
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
11734 Issued in MS
Practice address
11 Professional Pkwy
Ridgeland, MS 39157-4114
Phone
(601) 856-2460
Fax
(601) 856-5363
NPI assigned
Apr 9, 2015
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 11734 MS
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 11734 MS Primary

Addresses

Primary practice location

11 Professional Pkwy
Ridgeland, MS 39157-4114

Mailing address

11 Professional Pkwy
Ridgeland, MS 39157-4114
Phone (601) 856-2460

Other identifiers 1

IdentifierTypeStateIssuer
B2825WS4MSMedicaidMS

Other names 1

  • Dr. Wendy Glover Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20230531002412 MS Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6608267737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Mississippi School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indira IncGroup PAC ID 2668543349, 5 clinicians

Practice addresses (Care Compare)

11 Professional Pkwy
Ridgeland, MS 39157-4114
Phone (601) 856-2460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.37 of 100Reported as group
Quality
82.32
Improvement activities
0
Cost
74.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Dee Granger, M.D., P.a. CurrentSince May 17, 2023 Accepting new patients
Indira Inc CurrentSince May 17, 2023 Accepting new patients

Locations

11 Professional Pkwy
Ridgeland, MS 39157
Phone (601) 856-2460

Organizations & group practices 2

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 3

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1336535053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONAL PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574114",
            "telephone_number": "601-856-2460",
            "fax_number": "601-856-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONAL PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574114",
            "telephone_number": "601-856-2460",
            "fax_number": "601-856-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "WENDELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MS",
            "license": "11734",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MS",
            "license": "11734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B2825WS4MS",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "GLOVER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.