Glennon Joseph Fox, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

RIH06 Issued in MO

Practice address

777 South New Ballas Rd
231E
St Louis, MO 63141-8747

Phone

(314) 414-2273

Fax

(314) 414-2273

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• County of St Louis Division of Fiscal Management

  • Federally Qualified Health Center (FQHC)
  • Berkeley, MO
  • NPI 1184519506
  NPD (past)
• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1609960566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SOUTH NEW BALLAS RD",
            "address_2": "231E",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631418747",
            "telephone_number": "314-414-2273",
            "fax_number": "314-414-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SOUTH NEW BALLAS RD",
            "address_2": "231E",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631418747",
            "telephone_number": "314-414-2273",
            "fax_number": "314-414-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "GLENNON",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "RIH06",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latosha R Fowlkes, LCSW
• Alexander Christian Fox, RN, PMNHP-BC
• Benjamin Elliot Fox, MD
• Dainielle J Fox, PHARM.D.
• Daniel Kenneth Fox, M.D.
• Gregory Chandler Fox, MD, PHD
• Haley Fox, MD
• Ida Keiko Fox, MD
• James R Fox, LPC
• Jennifer Fox

• Family Medicine Physician in St Louis, MO
• Providers in St Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.