Individual provider Active NPI

Glenn Skow, M.D., MPH, FAAFP

  • Emergency Medicine Physician
  • Vandalia, IL
National Provider Identifier
1396987053
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036130323 Issued in IL
Practice address
650 W Taylor St
Vandalia, IL 62471-1227
Phone
(618) 283-5136
NPI assigned
Mar 27, 2009
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036130323 IL Primary
Family Medicine Physician 207Q00000X 258929 NY
Family Medicine Physician 207Q00000X 036130323 IL

Addresses

Primary practice location

650 W Taylor St
Vandalia, IL 62471-1227

Mailing address

825 New York Dr Ste 2
Vandalia, IL 62471-1044
Phone (618) 283-5545

Other practice location 1

233 Forest Ct
Edwardsville, IL 62025-5389
Phone (917) 514-8740

Other practice location 2

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20120829000085 IL Practitioner - Family PracticePractitioner - Emergency Medicine 8224285135 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Practice addresses (Care Compare)

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258929NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas H. Boyd Memorial Hospital CurrentSince Oct 1, 2024 Accepting new patients
Jersey Community Hospital CurrentSince Mar 22, 2023 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jun 11, 2012 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Thomas H. Boyd Memorial Hospital Current Accepting new patients
Jersey Community Hospital Family Medicine CurrentSince Mar 22, 2023 Accepting new patients
Jersey Community Hospital Current Accepting new patients
Thomas H. Boyd Memorial Hospital CurrentSince Oct 1, 2024 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jun 11, 2012 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Dec 31, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Dec 31, 2024 Accepting new patients
Alton-Griffin Emergency Group PC Emergency Medicine CurrentSince Apr 18, 2017 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

800 School St
Carrollton, IL 62016
Phone (217) 942-3600

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

400 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-6402

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

650 W Taylor St
Fl 2
Vandalia, IL 62471
Phone (217) 342-3400

825 New York Dr
Ste 2
Vandalia, IL 62471
Phone (618) 283-0600

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f4be81d1-a15e-4e19-9601-5214010ddaac/
  • FHIR API: https://fhir-usa.unify.chbase.com/org/jersey-f23a6357

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fayette CountyVandalia, IL, CCN 141607 Hospice Contracted Managing Employee Jul 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1396987053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 NEW YORK DR STE 2",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711044",
            "telephone_number": "618-283-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W TAYLOR ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711227",
            "telephone_number": "618-283-5136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 Forest Ct",
            "address_purpose": "LOCATION",
            "city": "Edwardsville",
            "state": "IL",
            "postal_code": "620255389",
            "country_code": "US",
            "telephone_number": "917-514-8740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Maple Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620522028",
            "country_code": "US",
            "telephone_number": "618-498-6402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKOW",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH, FAAFP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036130323",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "258929",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036130323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, IL

Sources for this page

Verify at the official NPI Registry.