Glenn Crotty Jr., MD
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Charleston, WV
NPI 1528025640 · NPPES record last updated Nov 20, 2014
Key facts
- NPI
- 1528025640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 10877 (WV)
- Practice address
- 501 Morris St
Charleston, WV 25301-1326 - Phone
- (304) 388-7647
- Fax
- (304) 388-7696
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Owned or controlled facilities with NPI records 17
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 7
| Facility | Type | Role | Since |
|---|---|---|---|
| Vandalia Health Charleston Area Medical Center |
Hospital | Corporate Director W-2 Managing Employee |
Mar 28, 2004 Mar 28, 2004 |
| Camc Greenbrier Valley Medical Center Inc |
Hospital | Corporate Director | Jan 1, 2023 |
| Camc Greenbrier Valley Medical Center Inc |
Hospital | Corporate Director | Jan 1, 2023 |
| Camc Plateau Medical Center |
Hospital | Corporate Director W-2 Managing Employee |
Dec 22, 2022 Dec 22, 2022 |
| Camc Plateau Medical Center |
Hospital | Corporate Director W-2 Managing Employee |
Dec 22, 2022 Dec 22, 2022 |
| Camc Primary Care -Summersville |
Rural health clinic | Corporate Director W-2 Managing Employee |
Mar 28, 2004 Mar 28, 2004 |
| Camc GVMC Primary Care - Peterstown |
Rural health clinic | Corporate Director W-2 Managing Employee |
Jan 1, 2023 Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150416001639 | WV | Order and Referring Only - Endocrinology |
3274430509 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camc Greenbrier Valley Medical Center, Inc. | Past |
Accepting new patients | |
| Camc Plateau Medical Center, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 10877 | WV | Yes |
Addresses
Primary practice location
501 Morris St
Charleston, WV 25301-1326
Mailing address
PO Box 1320
Saint Albans, WV 25177-1320
Phone (304) 388-1724
Other providers in Charleston, WV
- Sharon Crook
- Debra Cross
- Kimberly Sue Cross
- Emma Crotty
- Erin Traci Crotty
- Marie Ann Crouch
- Olivia Crouch
- Heather Lynn Crow
- Robert Joseph Crow Jr.
- Delisa Crowder
All providers in Charleston, WV · Endocrinology, Diabetes & Metabolism Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.