Active NPI
Glenn Alan Levine, CRT
- Certified Respiratory Therapist
- Fleming Island, FL
National Provider Identifier
1568856920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Respiratory Therapist
- License
- TT4696
- Practice address
- 1427 Golden Willow CT
Fleming Island, FL 32003-3210 - Phone
- (904) 228-1259
- NPI assigned
- Mar 24, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Respiratory Therapist | 227800000X | TT4696 | FL | Primary |
Addresses
Primary practice location
1427 Golden Willow CT
Fleming Island, FL 32003-3210
Mailing address
1427 Golden Willow CT
Fleming Island, FL 32003-3210
Phone (904) 228-1259
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TT4696 | Other | FL | FLORIDA DEPT. OF HEALTH |
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 |
|---|---|---|---|
| TT4696 | FL | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1568856920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1427 GOLDEN WILLOW CT",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320033210",
"telephone_number": "904-228-1259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1427 GOLDEN WILLOW CT",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320033210",
"telephone_number": "904-228-1259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "GLENN",
"middle_name": "ALAN",
"credential": "CRT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-24",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "227800000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified",
"state": "FL",
"license": "TT4696",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA DEPT. OF HEALTH",
"identifier": "TT4696",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fleming Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.