Active NPI
Glenn L Wing, M.D.
- Ophthalmology Physician
- Ft Myers, FL
National Provider Identifier
1497714422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME0039419
- Practice address
- 6901 International Center Blvd
Ft Myers, FL 33912-7125 - Phone
- (239) 939-4323
- Fax
- (239) 939-3983
- NPI assigned
- Mar 20, 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME0039419 | FL | Primary |
Addresses
Primary practice location
6901 International Center Blvd
Ft Myers, FL 33912-7125
Mailing address
PO Box 60559
Ft Myers, FL 33906-6559
Phone (239) 939-4323
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA7010 | Other | FL | RAILROAD MEDICARE GROUP |
| 043884700 | Medicaid | FL | |
| 374440000 | Medicaid | FL | |
| 180022163 | Other | FL | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| ME0039419 | FL | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Retina Vitreous Consultants | Ophthalmology | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228176000000",
"number": "1497714422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60559",
"city": "FT MYERS",
"state": "FL",
"postal_code": "339066559",
"telephone_number": "239-939-4323",
"fax_number": "239-939-3983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6901 INTERNATIONAL CENTER BLVD",
"city": "FT MYERS",
"state": "FL",
"postal_code": "339127125",
"telephone_number": "239-939-4323",
"fax_number": "239-939-3983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WING",
"first_name": "GLENN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-20",
"last_updated": "2008-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME0039419",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP",
"identifier": "CA7010",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043884700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "374440000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180022163",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.