Individual provider Active NPI

Glenn D. Meyers, M.D.

  • Internal Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1639319080
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52457 Issued in TN
Practice address
264A Palm Coast Pkwy NE
Palm Coast, FL 32137-8217
Phone
(386) 446-5505
NPI assigned
Feb 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME52232 FL
Internal Medicine Physician 207R00000X 0101258301 VA
Internal Medicine Physician 207R00000X 52457 TN Primary

Addresses

Primary practice location

264A Palm Coast Pkwy NE
Palm Coast, FL 32137-8217

Mailing address

333 Commerce St Ste 700
Nashville, TN 37201-1835
Phone (615) 454-9850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20031201000354 FL Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 8729983010 Reassigns benefits to 1 organization
I20181002002427 TN Practitioner - Internal Medicine 8729983010
I20181002002797 VA Practitioner - Internal Medicine 8729983010 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME52232FLMDInternal Medicine Physician
52457TNMDInternal Medicine Physician
0101258301VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Institute for Cardiovascular Care PA Past Accepting new patients
Carelon Medical Partners of Kansas, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: glenn.meyers@989059681681412.direct.elationemr.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1639319080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COMMERCE ST STE 700",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372011835",
            "telephone_number": "615-454-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264A PALM COAST PKWY NE",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378217",
            "telephone_number": "386-446-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "GLENN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME52232",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101258301",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.