Individual provider Active NPI

Romika Tanelle Glenn, RN, MSN, NP-C

  • Family Nurse Practitioner
  • Wyandotte, MI
National Provider Identifier
1346550753
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704218454 Issued in MI
Practice address
2025 Fort St
Wyandotte, MI 48192-3841
Phone
(734) 320-0525
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704218454 MI
Family Nurse Practitioner 363LF0000X 4704218454 MI Primary

Addresses

Primary practice location

2025 Fort St
Wyandotte, MI 48192-3841

Mailing address

8864 Grover St
Romulus, MI 48174-4124
Phone (734) 331-2494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110722000426 MI Practitioner - Nurse Practitioner 0446428189 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Michigan PCGroup PAC ID 9133123755, 40 clinicians

Practice addresses (Care Compare)

39350 9 Mile Rd
Northville, MI 48167-9164
Phone (866) 389-2727

45300 Cherry Hill Rd
Canton, MI 48187-5073
Phone (866) 389-2727

Merit-based Incentive Payment System (MIPS)

Final score
81.3 of 100Reported as group
Quality
76.96
Improvement activities
40
Cost
79.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care-Michigan PLLC Family CurrentSince Sep 12, 2025 Accepting new patients
Minuteclinic Diagnostic of Michigan PC Family CurrentSince Apr 8, 2011 Accepting new patients

Locations

45300 Cherry Hill Rd
Canton, MI 48187
Phone (734) 981-3968

44300 5 Mile Rd
Northville, MI 48168
Phone (734) 416-1883

39350 9 Mile Rd
Northville Township, MI 48167
Phone (248) 735-6081

2025 Fort St
Wyandotte, MI 48192
Phone (734) 283-9640

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1346550753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8864 GROVER ST",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481744124",
            "telephone_number": "734-331-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 FORT ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923841",
            "telephone_number": "734-320-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "ROMIKA",
        "middle_name": "TANELLE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704218454",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704218454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.