Active NPI
Carrie Glenn, DPT
- Physical Therapist
- Gorham, ME
National Provider Identifier
1730529207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT31055
- Practice address
- 94 Main St
Gorham, ME 04038-1340 - Phone
- (207) 839-5860
- Fax
- (207) 839-2499
- NPI assigned
- Jun 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT31055 | FL | Primary |
Addresses
Primary practice location
94 Main St
Gorham, ME 04038-1340
Mailing address
7205 Estero Blvd
Unit 5
Fort Myers Beach, FL 33931-4786
Phone (239) 314-5118
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458000000000",
"number": "1730529207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7205 ESTERO BLVD",
"address_2": "UNIT 5",
"city": "FORT MYERS BEACH",
"state": "FL",
"postal_code": "339314786",
"telephone_number": "239-314-5118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 MAIN ST",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381340",
"telephone_number": "207-839-5860",
"fax_number": "207-839-2499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "CARRIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-28",
"last_updated": "2016-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT31055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gorham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.