Active NPI
Leslie Anne Glenn, PT
- Physical Therapist
- Rock Hill, SC
National Provider Identifier
1497871594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3807
- Practice address
- 222 S Herlong Ave
Rock Hill, SC 29732-1158 - Phone
- (803) 329-6865
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3807 | SC | Primary |
| Physical Therapist | 225100000X | 7503 | NC |
Addresses
Primary practice location
222 S Herlong Ave
Rock Hill, SC 29732-1158
Mailing address
204 Pond View LN
Fort Mill, SC 29715-9755
Phone (803) 396-8935
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3807 | SC | MD | General Practice Dentistry |
| 7503 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497871594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 POND VIEW LN",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297159755",
"telephone_number": "803-396-8935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 S HERLONG AVE",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321158",
"telephone_number": "803-329-6865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "LESLIE",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "3807",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "7503",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.