Julie Ann Glenn, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1720 Issued in AR

Practice address

918 S Mount Olive St
Siloam Springs, AR 72761-4220

Phone

(479) 524-2456

NPI assigned

Jun 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Friendship Community Care Inc.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Russellville, AR
  • NPI 1528144318
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1538361001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72811",
            "telephone_number": "479-967-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 S MOUNT OLIVE ST",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614220",
            "telephone_number": "479-524-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "1720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145663721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesli D Fuson, PTA
• Jenny Gann
• David E Gates
• Nancy Lou Ghormley, LPC
• Jessica Gibson, LMSW
• Caitlin Dawn Goddard
• Rachel Fritsche Gordon, PA-C
• Megan Gotwalt
• Christina Gail Granderson, MHPP
• Peter Mark Granderson, APN, FNP-C

• Physical Therapy Assistant in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.