Individual provider Active NPI

Nikki Bell Glennon, PA-C

  • Physician Assistant
  • Apopka, FL
National Provider Identifier
1528165073
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0370 Issued in NH
Practice address
Carespot of Orlano-Apopka
3840 East State Road 436 Suite 1000
Apopka, FL 32703
Phone
(407) 478-3202
Fax
(407) 478-3245
NPI assigned
Sep 19, 2006
Last updated
Apr 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0370 NH Primary

Addresses

Primary practice location

Carespot of Orlano-Apopka
3840 East State Road 436 Suite 1000
Apopka, FL 32703

Mailing address

Carespot of Orlano-Apopka
3840 East State Road 436 Suite 1000
Apopka, FL 32703
Phone (407) 478-3202

Other practice location 1

Elliot Hospital
1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180524001059 FL Practitioner - Physician Assistant 9335145648 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carespot of Orlando Hsi Urgent Care LLCGroup PAC ID 8921372558, 55 clinicians

Practice addresses (Care Compare)

3840 State Rd
436 Suite 1000
Apopka, FL 32703-6041
Phone (615) 600-4074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
370NHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Merrimack Emergency Physicians Past Accepting new patients
Solantic of Jacksonville, LLC PastSince Sep 5, 2021 Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1528165073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARESPOT OF ORLANO-APOPKA",
            "address_2": "3840 EAST STATE ROAD 436 SUITE 1000",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "407-478-3202",
            "fax_number": "407-478-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARESPOT OF ORLANO-APOPKA",
            "address_2": "3840 EAST STATE ROAD 436 SUITE 1000",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "407-478-3202",
            "fax_number": "407-478-3245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Elliot Hospital",
            "address_2": "1 Elliot Way",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "03103",
            "country_code": "US",
            "telephone_number": "603-663-2830",
            "fax_number": "603-663-1849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "NIKKI",
        "middle_name": "BELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.