Individual provider Active NPI

Chris Glenn, MD

  • Diagnostic Radiology Physician
  • Anchorage, AK
National Provider Identifier
1457315533
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
8122 Issued in AK
Practice address
2741 Debarr Rd
Suite 401
Anchorage, AK 99508-2961
Phone
(907) 792-7975
Fax
(907) 792-7901
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G79975 CA
Diagnostic Radiology Physician 2085R0202X 8122 AK Primary
Vascular & Interventional Radiology Physician 2085R0204X 8122 AK

Addresses

Primary practice location

2741 Debarr Rd
Suite 401
Anchorage, AK 99508-2961

Mailing address

PO Box 140349
Anchorage, AK 99514-0349
Phone (907) 792-7975

Other identifiers 3

IdentifierTypeStateIssuer
00G799750OtherCABLUE SHIELD OF CA
00G799750MedicaidCA
1457315533MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150520000126 AK Practitioner - Diagnostic Radiology 4385720317 Reassigns benefits to 3 organizations
I20190701002182 TX Practitioner - Diagnostic Radiology 4385720317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.88 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79975CAMDPharmacist
8122AKMDDiagnostic Radiology Physician
G79975CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Oct 21, 2019 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jun 11, 2019 Accepting new patients
Medical Park Family Care, LLC CurrentSince Oct 26, 2020 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
McKinley Imaging, LLC Diagnostic Radiology CurrentSince Apr 13, 2022 Accepting new patients
South Peninsula Hospital, Inc CurrentSince Aug 9, 2022 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Oct 21, 2019 Accepting new patients
Valley Upright Imaging LLC Diagnostic Radiology CurrentSince Feb 25, 2021 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Anchorage Imaging Center LLC Diagnostic Radiology CurrentSince Jun 6, 2022 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
South Peninsula Hospital, Inc. Diagnostic Radiology CurrentSince Aug 9, 2022 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Salinas Valley Radiologists Diagnostic Radiology Past Accepting new patients
Salinas Valley Radiologists, Inc. Diagnostic Radiology Past Accepting new patients
Open Air MRI Centers Medical Group, Inc. Diagnostic Radiology PastSince Oct 14, 2013 Accepting new patients
Salinas Valley Radiologists, Inc. Diagnostic Radiology Past Accepting new patients
Salinas Valley Radiologists, Inc. Diagnostic Radiology Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

2110 E Northern Lights Blvd
Ste 101
Anchorage, AK 99508
Phone (907) 336-2273

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

2211 E Northern Lights Blvd
Anchorage, AK 99508
Phone (907) 257-8176

3745 Geist Rd
Fairbanks, AK 99709
Phone (907) 456-1112

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

3765 E Blue Lupine Dr
Ste B
Wasilla, AK 99654

Organizations & group practices 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1457315533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140349",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995140349",
            "telephone_number": "907-792-7975",
            "fax_number": "907-792-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD",
            "address_2": "SUITE 401",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082961",
            "telephone_number": "907-792-7975",
            "fax_number": "907-792-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "CHRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G79975",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "8122",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AK",
            "license": "8122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00G799750",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G799750",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457315533",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.