Individual provider Active NPI

Todd Roger Glenn

  • Chiropractor
  • Plant City, FL
National Provider Identifier
1508962192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006460 Issued in FL
Practice address
1215 W Baker St
Plant City, FL 33567-4309
Phone
(813) 754-2273
Fax
(813) 754-5680
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006460 FL Primary

Addresses

Primary practice location

1215 W Baker St
Plant City, FL 33567-4309

Mailing address

1215 W Baker St
Plant City, FL 33567-4309
Phone (813) 754-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080519000103 FL Practitioner - Chiropractic 4880763747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caring Concepts IncGroup PAC ID 6103912100, 2 clinicians

Practice addresses (Care Compare)

1215 W Baker St
Plant City, FL 33563-4309
Phone (813) 754-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0006460FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Concepts Inc Chiropractor CurrentSince Apr 30, 1998 Accepting new patients

Locations

1215 W Baker St
Plant City, FL 33563
Phone (813) 754-2273

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508962192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 W BAKER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335674309",
            "telephone_number": "813-754-2273",
            "fax_number": "813-754-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W BAKER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335674309",
            "telephone_number": "813-754-2273",
            "fax_number": "813-754-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "TODD",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

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.
  • 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.