Active NPI
Donna M Glynn, ANP
- Nurse Practitioner
- Quincy, MA
National Provider Identifier
1760417778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 147054
- Practice address
- 500 Congress Street
Suite 26
Quincy, MA 02169 - Phone
- (617) 479-4450
- Fax
- (617) 479-4499
- NPI assigned
- Jul 11, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 147054 | MA | Primary |
Addresses
Primary practice location
500 Congress Street
Suite 26
Quincy, MA 02169
Mailing address
500 Congress Street
Suite 2G
Quincy, MA 02169
Phone (617) 479-4450
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0356476 | Medicaid | MA | |
| GX9967 | Other | MA | MEDICARE PTAN # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147054 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Medical PC | Past | Accepting new patients | |
| Compass Medical PC | Past | Accepting new patients |
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.
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-
- General Practice Physician
- East Bridgewater, MA
- NPI 1962437962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250553600000",
"number": "1760417778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 CONGRESS STREET",
"address_2": "SUITE 2G",
"city": "QUINCY",
"state": "MA",
"postal_code": "02169",
"telephone_number": "617-479-4450",
"fax_number": "617-479-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CONGRESS STREET",
"address_2": "SUITE 26",
"city": "QUINCY",
"state": "MA",
"postal_code": "02169",
"telephone_number": "617-479-4450",
"fax_number": "617-479-4499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLYNN",
"first_name": "DONNA",
"middle_name": "M",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2009-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "147054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0356476",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN #",
"identifier": "GX9967",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.