Active NPI
Glenda N/a Phillips-Hickman, LPN
- Licensed Practical Nurse
- Spencer, NY
National Provider Identifier
1548532393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 09277-1
- Practice address
- 700 Washburn Rd
Spencer, NY 14883-9409 - Phone
- (607) 607-5897
- NPI assigned
- Feb 8, 2012
- Last updated
- Feb 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 09277-1 | NY | Primary |
Addresses
Primary practice location
700 Washburn Rd
Spencer, NY 14883-9409
Mailing address
244 Slate Rd
Candor, NY 13743-1718
Phone (607) 659-3839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09277-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1548532393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "244 SLATE RD",
"city": "CANDOR",
"state": "NY",
"postal_code": "137431718",
"telephone_number": "607-659-3839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 WASHBURN RD",
"city": "SPENCER",
"state": "NY",
"postal_code": "148839409",
"telephone_number": "607-607-5897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS-HICKMAN",
"first_name": "GLENDA",
"middle_name": "N/A",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-08",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "09277-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spencer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.