Glenda M Gensolin MD PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

4301090975 Issued in MI

Legal business name

GLENDA M GENSOLIN MD PLLC

Practice address

24 N Saint Joseph Ave Ste C2
Niles, MI 49120-2263

Phone

(269) 683-0330

Fax

(269) 684-0400

NPI assigned

Sep 4, 2007

Last updated

Mar 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glenda M Gensolin, MDNPI 1033195748

Title

President

Phone

(269) 683-0330

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenda M Gensolin, MD

  • Family Medicine Physician
  • Niles, MI
  • NPI 1033195748
  Authorized official Same address or phone

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1437343373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N SAINT JOSEPH AVE STE C2",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202263",
            "telephone_number": "269-683-0330",
            "fax_number": "269-684-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N SAINT JOSEPH AVE STE C2",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202263",
            "telephone_number": "269-683-0330",
            "fax_number": "269-684-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDA M GENSOLIN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "GENSOLIN",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-683-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301090975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033195748",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tsion Getahun
• Ghac3 Niles Mi Alf TRS Sub LLC (Brentwood of Niles Senior Living)
• Giva Tillman-Adkins (All Needs Senior Services)
• Lori F Glass, O.D.
• GLC Home Health Swmi LLC (Elara Caring)
• Antonio Ray Gonzales, D.C.
• Emma Goodling
• Jill L Gorsuch, DO, MPH
• Darrin Gourlay, D.D.S.
• Greater Niles Cardiology PC

• Primary Care Clinic/Center in Niles, MI
• Providers in Niles, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.