NPIMap

Individual provider Active NPI

Glynis Michelle Nordman, NP

  • Gerontology Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1700393493
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP09828 Issued in LA
Practice address
7777 Hennessy Blvd Ste 700
Baton Rouge, LA 70808-4300
Phone
(225) 765-2048
Fax
(225) 765-1958
NPI assigned
Jan 4, 2018
Last updated
Mar 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP09828 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 700
Baton Rouge, LA 70808-4300

Mailing address

5959 S Sherwood Forest Blvd # A11
Baton Rouge, LA 70816-6038
Phone (225) 526-0018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180410001350 LA Practitioner - Nurse Practitioner 7416210273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7777 Hennessy Blvd
Suite 700
Baton Rouge, LA 70808-4300
Phone (225) 765-2048

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP09828LAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Current Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Apr 1, 2018 Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

5959 S Sherwood Forest Blvd
#A11
Baton Rouge, LA 70816

7777 Hennessy Blvd
Ste 409
Baton Rouge, LA 70808
Phone (225) 765-1765

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1700393493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD # A11",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0018",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 700",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-765-2048",
            "fax_number": "225-765-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDMAN",
        "first_name": "GLYNIS",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "AP09828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.