Danielle Glesne, RD, LD
Individual provider Active NPI Registered Dietitian · Manchester, MO
NPI 1356697619 · NPPES record last updated Dec 10, 2024
Key facts
- NPI
- 1356697619
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2010035364 (MO)
- Practice address
- 4 Cottagemill CT
Manchester, MO 63021-6837 - Phone
- (314) 724-6503
- NPI assigned
- Jul 24, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Chicago, IL 60677
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260126000504 | MO | Practitioner - Registered Dietitian Or Nutrition Professional | 4082191630 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010035364 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic East Communities | Current |
Accepting new patients |
Locations
1203 Smizer Mill Rd
Ste 105
Fenton, MO 63026
Phone (636) 717-1350
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2010035364 | MO | Yes |
Addresses
Primary practice location
4 Cottagemill CT
Manchester, MO 63021-6837
Mailing address
4 Cottagemill CT
Manchester, MO 63021-6837
Other providers in Manchester, MO
- David Michael George
- Jeanette Gibson
- Payton Phillip Giesing
- Andrea Gilb
- Jasdeep Gill
- Tanja T Glosson
- Adeline Godsy
- Ihtesham Gohar
- Allison A Grace
- Alyce M Greene
All providers in Manchester, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.