Individual provider Active NPI

Sharon A Glandt, NP

  • Nurse Practitioner
  • Manitowoc, WI
National Provider Identifier
1649387572
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
669 Issued in WI
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

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
43847200MedicaidWI
0373980001OtherWIDMERC
1003310OtherWITOUCHPOINT
390806395OtherWICIGNA
10485OtherWINETWORK HEALTH PLAN
500004071OtherWIRAILROAD 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

LicenseStateTypeSpecialty
58411WIMDUrology Physician
669WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.