Byron Cornelius Glenn, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

108285 Issued in MO

Practice address

1353 N Mount Auburn Rd
Suite B
Cape Girardeau, MO 63701-1723

Phone

(573) 332-8400

Fax

(573) 332-8151

NPI assigned

Aug 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Byron Cornelius Glenn

  • Primary Care Clinic/Center
  • Cape Girardeau, MO
  • NPI 1790156032
  NPD (past) Authorized official

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1679766406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 N MOUNT AUBURN RD",
            "address_2": "SUITE B",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011723",
            "telephone_number": "573-332-8400",
            "fax_number": "573-332-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 N MOUNT AUBURN RD",
            "address_2": "SUITE B",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011723",
            "telephone_number": "573-332-8400",
            "fax_number": "573-332-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "BYRON",
        "middle_name": "CORNELIUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "108285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208155044",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer S Giza, DO
• Dennis N Glascock, DO
• Michael Anthony Glastetter II, DNP
• Glendale Assisted Living
• Glendale Assisted Living
• Hannah Marie Glueck
• Andrew Godbey, M.D.
• Melissa Goehman, P.T.
• Juan Gonzalez, MD
• Benjamin Goodman, D.O.

• Family Medicine Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.