Individual provider Active NPI

Meghan Elizabeth Glenn

  • Developmental Therapist
  • Gulfport, MS
National Provider Identifier
1659631380
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
800684947 Issued in MS
Practice address
46 45TH St
Gulfport, MS 39507-4019
Phone
(228) 234-3029
NPI assigned
May 29, 2012
Last updated
May 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 800684947 MS Primary

Addresses

Primary practice location

46 45TH St
Gulfport, MS 39507-4019

Mailing address

2708 NE 14TH St
Suite 5
Pompano Beach, FL 33062-3565
Phone (888) 880-9270

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
800684947MSMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1659631380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 NE 14TH ST",
            "address_2": "SUITE 5",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623565",
            "telephone_number": "888-880-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 45TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395074019",
            "telephone_number": "228-234-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "MEGHAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "MS",
            "license": "800684947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.