Jared Patrick Glenn, AP

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

3516 Issued in FL

Practice address

12273 US Highway 98 W Ste 120
Miramar Beach, FL 32550-6945

Phone

(850) 368-1685

NPI assigned

Jan 5, 2021

Last updated

Jan 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jade Lotus Acupuncture and Oriental Medicine

  dba jade lotus Inc.

  • Acupuncturist
  • Miramar Beach, FL
  • NPI 1457964280
  NPD Authorized official

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1841888963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 SCENIC GULF DR UNIT 7",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507022",
            "telephone_number": "850-368-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12273 US HIGHWAY 98 W STE 120",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325506945",
            "telephone_number": "850-368-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JARED",
        "middle_name": "PATRICK",
        "credential": "AP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "3516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galen Inpatient Physicians PC
• Michael Gallagher, PA-C
• Arleen Garrett
• Stephanie Gehringer, BCBA
• Matthew William George, MD
• Sarah Burden Gober, M.A., CCC-SLP
• Ralph C Goodman, M.D.
• True A Graham, RBT
• Grand Boulevard Operating Investments LLC
• Tara Margaret Grant, MS, BCBA

• Acupuncturist in Miramar Beach, FL
• Providers in Miramar Beach, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.