Glenn Marvin Campbell, OTRIL PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE000241L Issued in PA

Practice address

5955 Zeamer Ave
3Rd MDG
Elmendorf AFB, AK 99506-3702

Phone

(907) 580-1700

NPI assigned

Oct 26, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619967148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 METZGER AVE",
            "address_2": "UNIT A",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995062021",
            "telephone_number": "907-333-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "address_2": "3RD MDG",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "GLENN",
        "middle_name": "MARVIN",
        "credential": "OTRIL  PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE000241L",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC002460L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis F. Bond II, MD
• Kenneth Jerome Boomgaard, M.D.
• Patricia Brady, LCSW
• David Thomas Brown, RD
• Eric Brown, DDS
• Rafael Carbonell, MD
• Patrick Casey
• Erin Faith Chavet, DMD
• Lori J Chupp, M PA-S
• Jay Arthur Clemens, DO

• Physical Therapy Assistant in Elmendorf AFB, AK
• Providers in Elmendorf AFB, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.