Individual provider Active NPI

Glenna Carolyn Franke, D.O.

  • General Practice Physician
  • Bridgeton, MO
National Provider Identifier
1629077110
Registry record updated Feb 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
29322 Issued in MO
Practice address
3394 McKelvey Rd
Ste 113
Bridgeton, MO 63044-2531
Phone
(314) 291-3409
Fax
(314) 739-6798
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 29322 MO Primary
General Practice Physician 208D00000X 036056844 IL

Addresses

Primary practice location

3394 McKelvey Rd
Ste 113
Bridgeton, MO 63044-2531

Mailing address

3394 McKelvey Rd
Ste 113
Bridgeton, MO 63044-2531
Phone (314) 291-3409

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036056844ILMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266710400000",
    "number": "1629077110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3394 MCKELVEY RD",
            "address_2": "STE 113",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442531",
            "telephone_number": "314-291-3409",
            "fax_number": "314-739-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3394 MCKELVEY RD",
            "address_2": "STE 113",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442531",
            "telephone_number": "314-291-3409",
            "fax_number": "314-739-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKE",
        "first_name": "GLENNA",
        "middle_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "29322",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036056844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2010; 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.