Individual provider Active NPI

Glen Robert Tessman, D.C.

  • Chiropractor
  • Cleburne, TX
National Provider Identifier
1497875611
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9660 Issued in TX
Practice address
201 N Ridgeway Dr
Cleburne, TX 76033-4114
Phone
(817) 641-9700
Fax
(817) 641-8190
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9660 TX Primary

Addresses

Primary practice location

201 N Ridgeway Dr
Cleburne, TX 76033-4114

Mailing address

201 N Ridgeway Dr
Cleburne, TX 76033-4114
Phone (817) 641-9700

Other identifiers 1

IdentifierTypeStateIssuer
P00641259OtherTXRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000051 TX Practitioner - Chiropractic 5193619781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 N Ridgeway Dr
Cleburne, TX 76033-4114
Phone (817) 641-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Health and Rehabilitation, LLC Chiropractor CurrentSince Dec 1, 2007 Accepting new patients
Glen R Tessman PastSince Jan 1, 1990 Accepting new patients

Locations

306 Granbury St
Ste B
Cleburne, TX 76033
Phone (817) 641-9700

201 N Ridgeway Dr
Cleburne, TX 76033
Phone (817) 641-9700

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1497875611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N RIDGEWAY DR",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334114",
            "telephone_number": "817-641-9700",
            "fax_number": "817-641-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N RIDGEWAY DR",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334114",
            "telephone_number": "817-641-9700",
            "fax_number": "817-641-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESSMAN",
        "first_name": "GLEN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00641259",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.