Janene R Glyn, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

42887 Issued in MN

Practice address

1285 Nininger Rd
Hastings, MN 55033-1086

Phone

(651) 480-4200

NPI assigned

Mar 17, 2006

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, WY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jglyn189932@direct.centracare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centracare Clinic

  dba CentraCare - River Campus Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1043212665
  Medicare reassignment NPD
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment NPD
• St. Joseph's Medical Center

  dba Essentia Health-St. Joseph's Medical Center

  • General Acute Care Hospital
  • Brainerd, MN
  • NPI 1568415974
  Medicare reassignment NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment NPD
• Ivinson Memorial Hospital

  • Rural Health Clinic/Center
  • Laramie, WY
  • NPI 1033628599
  Medicare reassignment NPD
• Lander Valley Physician Practices, LLC

  • Psychiatry Physician
  • Lander, WY
  • NPI 1215971510
  Medicare reassignment NPD
• Memorial Hospital of Sweetwater County

  dba County of Sweetwater

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949
  Medicare reassignment NPD
• Range Regional Health Services

  dba HealthLine Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD
• St Joseph's Medical Center

  dba Essentia Health St Josephs Staples Clinic

  • Multi-Specialty Clinic/Center
  • Staples, MN
  • NPI 1538916101
  NPD
• St. Joseph's Medical Center

  dba Essentia Health St. Joseph's-Pine River Clinic

  • Primary Care Clinic/Center
  • Pine River, MN
  • NPI 1649223603
  NPD
• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1366626269
  NPD
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1518936863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 NININGER RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331086",
            "telephone_number": "651-480-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 NININGER RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331086",
            "telephone_number": "651-480-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 College Dr",
            "address_purpose": "LOCATION",
            "city": "Rock Springs",
            "state": "WY",
            "postal_code": "829015868",
            "country_code": "US",
            "telephone_number": "307-362-3711",
            "fax_number": "307-352-8454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLYN",
        "first_name": "JANENE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "8620A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "42887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1072689",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "12-00895",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "27F14GL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH EAU CLAIRE",
            "identifier": "34005200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "370020464",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9141025070",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP31065",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "127968",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA URGENT CARE",
            "identifier": "66-07835",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WI",
            "identifier": "34005200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190150800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jglyn189932@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jglyn189932@direct.centracare.com",
            "address_1": "1200 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563032735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Ray Geidel, D.C.
• Christine Elizabeth Gendreau, LAC
• Joan Gilbertson, RPH
• Kristen M Gilleo, FNP
• Mary Elizabeth Glaeser, RNCNP
• Patricia Dorothy Gosz, LICSW
• Grand St Paul CVS LLC (CVS Pharmacy # 10252)
• Rebecca C Grandstrand, CNP
• Julie Marie-Courts Greunke
• Kristin Grew, MAAC-AP, LADC

• Pediatrics Physician in Hastings, MN
• Providers in Hastings, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.