DRS Glenn and Glenn Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

11533 Issued in KS

Legal business name

DRS GLENN AND GLENN INC

Practice address

702 N Kansas
Russell, KS 67665-0535

Phone

(785) 483-2451

Fax

(785) 483-4986

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Melanie B Banks

Title

Office Manager

Phone

(785) 483-2451

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• DRS Glenn & Glenn Inc

  • Optometrist
  • Russell, KS
  • NPI 1518089374

  Member Of

  NPD member

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1356437552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535",
            "city": "RUSSELL",
            "state": "KS",
            "postal_code": "676650535",
            "telephone_number": "785-483-2451",
            "fax_number": "785-483-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N KANSAS",
            "city": "RUSSELL",
            "state": "KS",
            "postal_code": "676650535",
            "telephone_number": "785-483-2451",
            "fax_number": "785-483-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS GLENN AND GLENN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "785-483-2451"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "11533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100219210B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha May Dortland
• Audrey Ann Dougherty, APRN
• Kyla Jae Driscoll
• Samantha Driscoll
• DRS Glenn & Glenn Inc
• Kyle Ray Drummond
• Isaiah Christopher Edmonds
• Lillian Marie Ervin
• Eugene M. Davidson, D.C.P.a.
• Megan Annika Flavin

• All providers in Russell, KS
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.