John L Glenn, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1575271 Issued in NY

Practice address

84 E. State St
St. Mary's Hospital, Gloversville Fam HLTH CNTR
Gloversville, NY 12078

Phone

(518) 773-8894

Fax

(518) 773-8125

NPI assigned

May 3, 2006

Last updated

Sep 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• St Marys Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1518926401
  Medicare reassignment NPD
• John L Glenn MD

  dba Mountain Medical

  • General Practice Physician
  • Gloversville, NY
  • NPI 1568423051
  Authorized official Same address or phone
• St. Mary's Healthcare

  dba Opioid Treatment Program

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Amsterdam, NY
  • NPI 1700636347
  NPD
• Amsterdam Memorial Hospital

  • Skilled Nursing Facility
  • Amsterdam, NY
  • NPI 1578624599
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1821056433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE - PRIMARY & SPECIALTY CARE DEPT.",
            "address_2": "ST. MARY'S HOSPITAL AT AMSTERDAM",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-841-7430",
            "fax_number": "518-841-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 E. STATE ST",
            "address_2": "ST. MARY'S HOSPITAL, GLOVERSVILLE FAM HLTH CNTR",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-773-8894",
            "fax_number": "518-773-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "1575271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00890859",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Gennett, MSPT
• Genoa Healthcare LLC
• Taylor Lee Gifford
• Obafemi O Giwa-Amu, M.D.
• Keira Glasheen, AU.D.
• Gloversville Chiropractic & Physical Therapy, PLLC
• Gloversville Emergency Medicine Services PC
• Gloversville Enlarged School District
• Gloversville Family Dentistry,LLP
• Gloversville Physician Medicine Services PC

• General Practice Physician in Gloversville, NY
• Providers in Gloversville, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.