Individual provider Active NPI

Glenda M Cain, RN,FNP

  • Nurse Practitioner
  • Grand Junction, CO
National Provider Identifier
1740394808
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
106236 Issued in CO
Practice address
2570 Patterson Rd
Grand Junction, CO 81505-1438
Phone
(970) 298-6601
Fax
(970) 298-6641
NPI assigned
Aug 18, 2006
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 106236 CO Primary

Addresses

Primary practice location

2570 Patterson Rd
Grand Junction, CO 81505-1438

Mailing address

2503 Foresight Cir
Grand Junction, CO 81505-1139
Phone (970) 242-2660

Other identifiers 1

IdentifierTypeStateIssuer
35331259MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050117000503 CO Practitioner - Nurse Practitioner 7012966005 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Dec 28, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Dec 28, 2020 Accepting new patients
Havasu Regional Medical Center LLC Past Accepting new patients
Mountain Radiology, Inc Past Accepting new patients
UC Physicians of Parker Az Nurse Practitioner Past Accepting new patients
Urgent Care of Wyoming Inc. Nurse Practitioner Past Accepting new patients
Cheyenne Regional Physicians Group, LLC PastSince Dec 12, 2021 Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2503 Foresight Cir
Grand Junction, CO 81505
Phone (970) 242-2660

2570 Patterson Rd
Grand Junction, CO 81505
Phone (970) 298-6601

Interoperability endpoints

  • Direct secure messaging: glenda.cain.1@16660.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1740394808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 FORESIGHT CIR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051139",
            "telephone_number": "970-242-2660",
            "fax_number": "970-242-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 PATTERSON RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051438",
            "telephone_number": "970-298-6601",
            "fax_number": "970-298-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "GLENDA",
        "middle_name": "M",
        "credential": "RN,FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-10-14",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "106236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35331259",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.