Jade Alize Glenn

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

9081 Issued in ID

Practice address

10790 W Overland Rd
Boise, ID 83709-1329

Phone

(208) 467-7889

NPI assigned

Jun 6, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690
  NPD

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1831931302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10790 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091329",
            "telephone_number": "208-467-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JADE",
        "middle_name": "ALIZE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "9081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin A Glass, M.D.
• Anna Glatt
• Steven Glazier, PT
• Glen K Stephenson DMD Chartered
• Glen S Lovelace MD PA
• Janis Glenn, MSW, LCSW
• Jonathan Weldon Glick, LPCP
• Global Drug Testing Labs
• Global Health Services LLC.
• Cyndia Kay Glorfield, M.COUN., LPC

• Physical Therapy Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.