Active NPI
Glenn Newsom
- Professional Counselor
- Greensboro, NC
National Provider Identifier
1841339751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4085
- Practice address
- 2307 W Cone Blvd Ste 100
Greensboro, NC 27408-4027 - Phone
- (336) 662-8185
- Fax
- (336) 665-6188
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4085 | NC | Primary |
Addresses
Primary practice location
2307 W Cone Blvd Ste 100
Greensboro, NC 27408-4027
Mailing address
2307 W Cone Blvd Ste 100
Greensboro, NC 27408-4027
Phone (336) 662-8185
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 138X0 | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4085 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841339751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2307 W CONE BLVD STE 100",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274084027",
"telephone_number": "336-662-8185",
"fax_number": "336-665-6188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2307 W CONE BLVD STE 100",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274084027",
"telephone_number": "336-662-8185",
"fax_number": "336-665-6188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWSOM",
"first_name": "GLENN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4085",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "138X0",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.