Jonathan Coleman Glen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

7816 Issued in SC

Practice address

716 E 71St St
Savannah, GA 31405-4907

Phone

(912) 355-1533

Fax

(912) 355-5984

NPI assigned

Jan 8, 2007

Last updated

Mar 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Beaufort Jasper Hampton Comprehensive Health Services, Inc.

  dba BJHCHS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ridgeland, SC
  • NPI 1649276148
  Medicare reassignment
• Abercorn Family Medical Center

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1841579067

  Single Specialty

  NPD (past)
• Fetter Health Care Network, Inc.

  dba Fetter Health Care Network-Downtown Site

  • Federally Qualified Health Center (FQHC)
  • Charleston, SC
  • NPI 1003827304

  Single Specialty

  NPD (past)
• Fetter Health Care Network, Inc.

  dba Community Dental Center

  • Dental Clinic/Center
  • Charleston, SC
  • NPI 1245639095
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1407904493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 OKATIE HWY # 170",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "299093963",
            "telephone_number": "843-987-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E 71ST ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054907",
            "telephone_number": "912-355-1533",
            "fax_number": "912-355-5984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6315 Jonathan Francis SR Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Helena Island",
            "state": "SC",
            "postal_code": "299205310",
            "country_code": "US",
            "telephone_number": "843-838-2086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 Okatie Hwy # 170",
            "address_purpose": "LOCATION",
            "city": "Okatie",
            "state": "SC",
            "postal_code": "299093963",
            "country_code": "US",
            "telephone_number": "843-987-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEN",
        "first_name": "JONATHAN",
        "middle_name": "COLEMAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "21984",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "7816",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "7816",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00234429A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G07186",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Glass
• Sierra Glass, CAA
• Keylon A Glawson, MD
• James R Glazier Jr., CRNA
• Cindy Ann Gleit, MD
• Bonnie L Glenn, LPC
• Chris Glenn, PHD, NCACI
• Robert T Glenn Jr., MD
• Shannon Corbett Glenn, CRNA
• David Norwood Glisson Sr., L.M.T.

• Internal Medicine Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.