Individual provider Active NPI

Glenn Lefor, CRNA

  • Certified Registered Nurse Anesthetist
  • Dickinson, ND
National Provider Identifier
1619991973
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R31505 Issued in ND
Practice address
30 7TH St W
Dickinson, ND 58601-4335
Phone
(701) 456-4000
Fax
(701) 456-4800
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R31505 ND Primary

Addresses

Primary practice location

30 7TH St W
Dickinson, ND 58601-4335

Mailing address

30 7TH St W
Dickinson, ND 58601-4335
Phone (701) 456-4000

Other names 1

  • Glenn Lefor Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000118 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012922412 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph'S Hospital and Health CenterGroup PAC ID 0547177560, 157 clinicians

Practice addresses (Care Compare)

2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 456-4000

95 NW 2ND St
Beach, ND 58621
Phone (701) 872-3777

Hospital & facility affiliations

  • CHI St Alexius Health Dickinson Hospital, Dickinson, ND, CCN 351336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R31505NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Hospital and Health Center Current Accepting new patients
West River Health Services CurrentSince Nov 13, 2023 Accepting new patients
West River Health Services Current Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Dec 20, 2005 Accepting new patients
St Josephs Hospital and Health Center CurrentSince Dec 20, 2005 Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Jan 1, 2025 Accepting new patients
West River Health Services Current Accepting new patients

Locations

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

30 7th St W
Dickinson, ND 58601
Phone (701) 264-4000

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

4784 Amber Valley Pkwy S
Fargo, ND 58104

1000 Highway 12
Hettinger, ND 58639
Phone (701) 567-4561

Organizations & group practices 7

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.

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619991973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 7TH ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014335",
            "telephone_number": "701-456-4000",
            "fax_number": "701-456-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 7TH ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014335",
            "telephone_number": "701-456-4000",
            "fax_number": "701-456-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFOR",
        "first_name": "GLENN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R31505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENN",
            "last_name": "LEFOR",
            "credential": "CRNA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.