NPIMap

Organization Active NPI

Glenn E. Fussell

  • Geriatric Medicine (Family Medicine) Physician
  • Columbus, GA
National Provider Identifier
1770766909
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
026777 Issued in GA
Legal business name
GLENN E. FUSSELL
Practice address
2827 Warm Springs Rd
Suite 3B
Columbus, GA 31904-5246
Phone
(706) 324-4177
Fax
(706) 322-9637
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Glenn E. Fussell, M.D.NPI 1861509184
Title
Owner
Phone
(706) 324-4177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X 026777 GA Primary

Addresses

Primary practice location

2827 Warm Springs Rd
Suite 3B
Columbus, GA 31904-5246

Mailing address

2827 Warm Springs Rd
Suite 3B
Columbus, GA 31904-5246
Phone (706) 324-4177

Other identifiers 4

IdentifierTypeStateIssuer
08BDPHDOtherMEDICARE PTAN
GRP4568OtherMEDICARE, PTAN
DG5108OtherGARAILROAD MEDICARE GRP NUM
00330063CMedicaidGA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0266658Glenn E Fussell MD2827 Warm Springs Rd Suite 3-B, Columbus, GA 31904Provider-performed microscopyAug 9, 2026

National Provider Directory

National Provider Directory

Locations

2827 Warm Springs Rd
Columbus, GA 31904

Interoperability endpoints

  • Direct secure messaging: glenn.fussell@gfussell.gadirect.net

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1770766909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 WARM SPRINGS RD",
            "address_2": "SUITE 3B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319045246",
            "telephone_number": "706-324-4177",
            "fax_number": "706-322-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 WARM SPRINGS RD",
            "address_2": "SUITE 3B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319045246",
            "telephone_number": "706-324-4177",
            "fax_number": "706-322-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN E. FUSSELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "FUSSELL",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-324-4177",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "026777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "08BDPHD",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, PTAN",
            "identifier": "GRP4568",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP NUM",
            "identifier": "DG5108",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330063C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.