Kahlil S Glenn, M.D.

Primary specialty

Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X

License

01056694 Issued in IN

Practice address

150 W Washington St
Shelbyville, IN 46176-1236

Phone

(317) 392-3211

Fax

(317) 421-2131

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

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 1

Specialty

Anesthesiology

Education

Mayo Medical School, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mercy Medical Center

  • Psychiatry Physician
  • Cedar Rapids, IA
  • NPI 1700834165
  Medicare reassignment Care Compare group

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

• Mercy Medical Center

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1720029333
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1386665032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E STATE ROAD 44",
            "address_2": "SUITE B",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461764026",
            "telephone_number": "317-421-2012",
            "fax_number": "317-421-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W WASHINGTON ST",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461761236",
            "telephone_number": "317-392-3211",
            "fax_number": "317-421-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "KAHLIL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "IN",
            "license": "01056694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "01056694",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000392328",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "PENDING",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anu George, NP
• Lindsey A Gessendorf, LCSW
• Alyssa Mae Rose Gibson
• Caprice Gilpin, M.D.
• Caine Gindling
• Paul Gold Jr., CAPRC I
• Goodwill Industries of Central Indiana, Inc.
• Kristina Gossett, O.T
• Grace House Ministries
• Angela R. Green, NP

• Critical Care Medicine (Anesthesiology) Physician in Shelbyville, IN
• Providers in Shelbyville, IN by specialty
• Critical Care Medicine (Anesthesiology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.