Individual provider Active NPI

Lynn Marie Taylor Glass, DPT

  • Physical Therapist
  • Springfield, MA
National Provider Identifier
1497050934
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22039 Issued in MA
Practice address
516 Carew St
Springfield, MA 01104-2330
Phone
(413) 735-1363
NPI assigned
Jan 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT24688 FL
Physical Therapist 225100000X 22039 MA Primary

Addresses

Primary practice location

516 Carew St
Springfield, MA 01104-2330

Mailing address

123 Academy Dr
Longmeadow, MA 01106-2158
Phone (317) 371-1215

Other names 1

  • Lynn Marie Taylor Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228002232 MA Practitioner - Physical Therapist in Private Practice 1759731011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22039MAMDPhysical Therapist
PT24688FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Shriners' Hospital for Children CurrentSince Nov 7, 2023 Accepting new patients
The Shriners' Hospital for Children Current Accepting new patients

Locations

516 Carew St
Springfield, MA 01104
Phone (413) 787-2000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1497050934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ACADEMY DR",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011062158",
            "telephone_number": "317-371-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 CAREW ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042330",
            "telephone_number": "413-735-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR GLASS",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-13",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT24688",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "TAYLOR",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.