Active NPI
Glen R Bair, M.D.
- Orthopaedic Surgery Physician
- Phoenix, AZ
National Provider Identifier
1417907114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 8968
- Practice address
- 690 N Cofco Center CT
Ste 290
Phoenix, AZ 85008-6474 - Phone
- (602) 631-3161
- Fax
- (602) 631-3162
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 8968 | AZ | Primary |
Addresses
Primary practice location
690 N Cofco Center CT
Ste 290
Phoenix, AZ 85008-6474
Mailing address
PO Box 29870
Phoenix, AZ 85038-9870
Phone (602) 772-3800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204488 | Medicaid | AZ | |
| 3Z3921 | Other | AZ | HEALTHNET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8968 | AZ | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Specialists of North America, PLLC | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Gilbert, AZ
- NPI 1962292870
Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1417907114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29870",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850389870",
"telephone_number": "602-772-3800",
"fax_number": "602-772-3801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 N COFCO CENTER CT",
"address_2": "STE 290",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850086474",
"telephone_number": "602-631-3161",
"fax_number": "602-631-3162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAIR",
"first_name": "GLEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AZ",
"license": "8968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204488",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "3Z3921",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.