Individual provider Active NPI

Glenn Benard McKenna, MD

  • Emergency Medicine Physician
  • Anderson, SC
National Provider Identifier
1609941251
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2017039490 Issued in MO
Practice address
800 N Fant St
Anderson, SC 29621-5708
Phone
(864) 512-1000
NPI assigned
Nov 21, 2006
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 82260 SC
Emergency Medicine Physician 207P00000X 4301508615 MI
Emergency Medicine Physician 207P00000X 2017039490 MO Primary

Addresses

Primary practice location

800 N Fant St
Anderson, SC 29621-5708

Mailing address

1116 Parker PL NE
Atlanta, GA 30324-5402
Phone (404) 931-7978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MO, SC, KY, IA5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20080605000127 GA Practitioner - Emergency Medicine 3678643426 Reassigns benefits to 1 organization
I20171114003595 MO Practitioner - Emergency Medicine 3678643426 Reassigns benefits to 5 organizations
I20190822002725 SC Practitioner - Emergency Medicine 3678643426 Reassigns benefits to 1 organization
I20231027002207 KY Practitioner - Emergency Medicine 3678643426 Reassigns benefits to 4 organizations
I20240520002554 IA Practitioner - Emergency Medicine 3678643426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockcastle Emergency Group, LLCGroup PAC ID 3971923814, 15 clinicians
Concord Medical Group of Kentucky PLLCGroup PAC ID 9133483894, 78 clinicians
Woodbury Emergency Group, PCGroup PAC ID 2961737317, 16 clinicians

Practice addresses (Care Compare)

145 Newcomb Ave
Mount Vernon, KY 40456-2728
Phone (606) 256-2195

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

801 5TH St
Sioux City, IA 51101-1326
Phone (712) 279-2010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301508615MIMDEmergency Medicine Physician
82260SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Cassville CurrentSince Sep 1, 2021 Accepting new patients
Ich ER Services, LLC Emergency Medicine CurrentSince Jun 15, 2019 Accepting new patients
Rockcastle Emergency Group, LLC Emergency Medicine CurrentSince Sep 12, 2023 Accepting new patients
Mercy Hospital Cassville CurrentSince Sep 1, 2021 Accepting new patients
Mercy Hospital Aurora CurrentSince Sep 1, 2021 Accepting new patients
Concord Medical Group of Kentucky PLLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Ohio County Hospital Corporation Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Ohio County Hospital Corporation Current Accepting new patients
South Central Physicians PLLC CurrentSince Oct 2, 2024 Accepting new patients
Ohio County Hospital Corporation CurrentSince Apr 1, 2025 Accepting new patients
Woodbury Emergency Group, PC Emergency Medicine CurrentSince Apr 14, 2024 Accepting new patients
Mercy Hospital Aurora CurrentSince Sep 1, 2021 Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine CurrentSince Mar 1, 2018 Accepting new patients
Potosi Emergency Group, LLC Emergency Medicine CurrentSince Feb 25, 2021 Accepting new patients
Missouri HB Medical Services, LLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Parkway Anesthesia Consultants, PC Past Accepting new patients
Emerginet SRMC, LLC Emergency Medical Services Past Accepting new patients
24 On Physicians, PC Past Accepting new patients
Immediate Care Centers of Georgia, LLC PastSince Feb 1, 2008 Accepting new patients
Emerginet Henry, LLC Emergency Medical Services Past Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

801 5th St
Sioux City, IA 51101
Phone (712) 279-2010

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

1011 Old Highway 60
Hardinsburg, KY 40143
Phone (270) 756-7000

1211 Old Main St
Hartford, KY 42347
Phone (270) 298-3806

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

4604 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-5000

145 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-2195

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

300 Health Way Dr
Potosi, MO 63664
Phone (573) 438-2977

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 4

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1609941251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 PARKER PL NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245402",
            "telephone_number": "404-931-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "GLENN",
        "middle_name": "BENARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "82260",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301508615",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2017039490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.