Active NPI
Sharon A Glandt, NP
- Nurse Practitioner
- Manitowoc, WI
National Provider Identifier
1649387572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 669
- Practice address
- 1235 S 24TH St
Manitowoc, WI 54220-5516 - Phone
- (920) 320-6620
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 58411 | WI | |
| Nurse Practitioner | 363L00000X | 669 | WI | Primary |
Addresses
Primary practice location
1235 S 24TH St
Manitowoc, WI 54220-5516
Mailing address
PO Box 2290
Manitowoc, WI 54221-2290
Phone (920) 320-2591
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43847200 | Medicaid | WI | |
| 0373980001 | Other | WI | DMERC |
| 1003310 | Other | WI | TOUCHPOINT |
| 390806395 | Other | WI | CIGNA |
| 10485 | Other | WI | NETWORK HEALTH PLAN |
| 500004071 | Other | WI | RAILROAD MEDICARE |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58411 | WI | MD | Urology Physician |
| 669 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Radiology Associates SC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Manitowoc, WI
- NPI 1346265915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1649387572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2290",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542212290",
"telephone_number": "920-320-2591",
"fax_number": "920-320-4155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 S 24TH ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542205516",
"telephone_number": "920-320-6620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLANDT",
"first_name": "SHARON",
"middle_name": "A",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "58411",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "669",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43847200",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0373980001",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TOUCHPOINT",
"identifier": "1003310",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "390806395",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH PLAN",
"identifier": "10485",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500004071",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.