Kelly Ann Glas, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95021834 Issued in CA

Practice address

8851 Center Dr Ste 408
La Mesa, CA 91942-3076

Phone

(619) 583-1174

NPI assigned

Jul 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kglas64928@sharphealthcare.direct-ci.com

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.

• Majid Shahbaz MD Inc

  • Geriatric Medicine (Internal Medicine) Physician
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  • NPI 1295839934
  Medicare reassignment NPD

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1790410033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14111 CHICARITA CREEK RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283611",
            "telephone_number": "858-437-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR STE 408",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423076",
            "telephone_number": "619-583-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAS",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95021834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Edward Giles, O.D.
• Barry Francis Gillen, MFT
• Ginos Wide Shoes & Shoe Repair
• Gioi Ngoc Smith-Nguyen MD a Medical Corporation
• Maricela Giron, RBT
• Lindsey Glasheen
• Kimberley Glasson, RPH
• Timothy Lee Glaze
• Gloria L Mayora-Mejia DDS Inc
• Glorious Strands

• Primary Care Nurse Practitioner in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.