Individual provider Active NPI

Janette Andrea Glass, N.P.

  • Family Nurse Practitioner
  • Carthage, IL
National Provider Identifier
1568539211
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209004070 Issued in IL
Practice address
403 S Adams St
Suite 239
Carthage, IL 62321-1624
Phone
(217) 357-0617
Fax
(217) 357-0615
NPI assigned
Nov 29, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209004070 IL Primary

Addresses

Primary practice location

403 S Adams St
Suite 239
Carthage, IL 62321-1624

Mailing address

PO Box 160
Carthage, IL 62321-0160
Phone (217) 357-0617

Other identifiers 1

IdentifierTypeStateIssuer
209004070MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040527000143 IL Practitioner - Nurse Practitioner 4183605942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital AssociationGroup PAC ID 0244134682, 39 clinicians

Practice addresses (Care Compare)

1454 N Co Rd 2050
PO Box 160
Carthage, IL 62321-0160

1454 N County Rd
Suite 2050
Carthage, IL 62321-0160
Phone (217) 357-8500

PO Box
Suite 160
Carthage, IL 62321-0160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209004070ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Memorial Hospital Association CurrentSince May 20, 2011 Accepting new patients
Memorial Hospital Association CurrentSince May 20, 2011 Accepting new patients
Memorial Hospital Association Current Accepting new patients

Locations

1450 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-2173

1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131

403 S Adams St
Ste 239
Carthage, IL 62321
Phone (217) 357-0617

630 Locust St
Carthage, IL 62321
Phone (217) 357-2173

Interoperability endpoints

  • Direct secure messaging: jglass584759@direct.unitypoint.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1568539211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623210160",
            "telephone_number": "217-357-0617",
            "fax_number": "217-357-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S ADAMS ST",
            "address_2": "SUITE 239",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623211624",
            "telephone_number": "217-357-0617",
            "fax_number": "217-357-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "JANETTE",
        "middle_name": "ANDREA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209004070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209004070",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, IL

Sources for this page

Verify at the official NPI Registry.