Individual provider Active NPI

Walter R. Glauber, NP

  • Family Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1821210287
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.001302 Issued in IL
Practice address
311 W Lincoln St
Ste 201
Belleville, IL 62263-1902
Phone
(618) 222-3200
Fax
(618) 222-3203
NPI assigned
May 3, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 097839 MO
Family Nurse Practitioner 363LF0000X 209.001302 IL Primary
Registered Nurse 163W00000X 097839 MO
Registered Nurse 163W00000X 041-201910 IL

Addresses

Primary practice location

311 W Lincoln St
Ste 201
Belleville, IL 62263-1902

Mailing address

311 W Lincoln St
Ste 201
Belleville, IL 62263-1902
Phone (618) 222-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070626000119 MO Practitioner - Nurse Practitioner 9830298272 Reassigns benefits to 1 organization
I20080527000302 IL Practitioner - Nurse Practitioner 9830298272 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041-201910ILMDRegistered Nurse
097839MOMDRegistered Nurse
209.001302ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro East Healthcare Limited CurrentSince Jan 2, 2024 Accepting new patients
County of St Louis Division of Fiscal Management CurrentSince Aug 1, 2017 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Aug 8, 2022 Accepting new patients
County of St Louis Division of Fiscal Management CurrentSince Aug 1, 2017 Accepting new patients
Diabetes Thyroid and Osteoporosis Clinic of Southern Illinois LTD Past Accepting new patients

Locations

27 Auerbach Pl
Glen Carbon, IL 62034
Phone (618) 277-3700

600 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 325-9630

2133 Vadalabene Dr
Ste 5B
Maryville, IL 62062
Phone (618) 288-7605

6121 N Hanley Rd
Saint Louis, MO 63134
Phone (314) 522-6410

6121 N Hanley Rd
#C
Saint Louis, MO 63134
Phone (314) 615-0500

L2540
Columbus, OH 43260

Interoperability endpoints

  • Direct secure messaging: walter.glauber@ccrh.directbygreenway.com

Organizations & group practices 5

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1821210287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST",
            "address_2": "STE 201",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622631902",
            "telephone_number": "618-222-3200",
            "fax_number": "618-222-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST",
            "address_2": "STE 201",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622631902",
            "telephone_number": "618-222-3200",
            "fax_number": "618-222-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAUBER",
        "first_name": "WALTER",
        "middle_name": "R.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "097839",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.001302",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "097839",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-201910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.