Individual provider Active NPI

Judith Kay Glann, ACNP-BC

  • Acute Care Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1851395743
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
295295 Issued in AZ
Practice address
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone
(928) 773-0003
Fax
(928) 773-1170
NPI assigned
Jun 8, 2005
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 202100603NP-PP OR
Acute Care Nurse Practitioner 363LA2100X AP60271836 WA
Critical Care Medicine Nurse Practitioner 363LC0200X 0387031 MD
Acute Care Nurse Practitioner 363LA2100X 295295 AZ Primary

Addresses

Primary practice location

1003 Willow Creek Rd
Prescott, AZ 86301-1641

Mailing address

PO Box 26335
Prescott Valley, AZ 86312-6335
Phone (206) 556-9828

Other identifiers 2

IdentifierTypeStateIssuer
134107MedicaidAZ
1851395743MedicaidWA

Other names 1

  • Judith Glann Mitchell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AZ2 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
I20160926001696 WA Practitioner - Nurse Practitioner 1951345552 Reassigns benefits to 1 organization
I20230911003165 AZ Practitioner - Nurse Practitioner 1951345552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Francisco School of Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

555 E River Rd
Suite 101
Tucson, AZ 85704-5843

PO Box
Suite 50298
Eugene, OR 97405-0975

PO Box
Suite 967
Flagstaff, AZ 86002-0967

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.17 of 100Reported as group
Quality
83.77
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295295AZMDAcute Care Nurse Practitioner
202100603NP-PPORMDAcute Care Nurse Practitioner
AP60271836WAMDAcute Care Nurse Practitioner
0387031MDMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Nurse Practitioner Current Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Jun 1, 2021 Accepting new patients
Critical Care Consultants of Arizona PLLC CurrentSince Feb 10, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Jun 1, 2021 Accepting new patients
Cogent Healthcare of Washington, PC Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
New Mexico Heart Institute, LLC Past Accepting new patients

Locations

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Interoperability endpoints

  • Direct secure messaging: jglann217731@direct.integrisok.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1851395743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26335",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863126335",
            "telephone_number": "206-556-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011641",
            "telephone_number": "928-773-0003",
            "fax_number": "928-773-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANN",
        "first_name": "JUDITH",
        "middle_name": "KAY",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "202100603NP-PP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60271836",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MD",
            "license": "0387031",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "295295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134107",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851395743",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "MITCHELL",
            "middle_name": "GLANN",
            "credential": "ACNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.