Individual provider Active NPI

Jared William Glenn, M.D.

  • Emergency Medicine Physician
  • Temple, TX
National Provider Identifier
1700266285
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
BP10054649 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(801) 244-0886
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X BP10054649 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

2401 S 31St St
Temple, TX 76508-0001
Phone (801) 244-0886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180716002135 UT Practitioner - Emergency Medicine 3173804515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Valley Emergency Physicians IncGroup PAC ID 2860390879, 34 clinicians

Practice addresses (Care Compare)

331 N 400
Orem, UT 84057-1913
Phone (801) 224-4080

Hospital & facility affiliations

  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062
  • Orem Community Hospital Hospital, Orem, UT, CCN 460043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10054649TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Valley Emergency Physicians Inc Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Locations

331 N 400 W
Orem, UT 84057
Phone (801) 224-4080

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

765 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-5000

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1700266285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "801-244-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "801-244-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JARED",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "BP10054649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.