Individual provider Active NPI

Glenn Matthews Adams, NP

  • Family Nurse Practitioner
  • Clinton, LA
National Provider Identifier
1851670277
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP200591 Issued in LA
Practice address
11990 Jackson St
Clinton, LA 70722-3210
Phone
(225) 683-5292
Fax
(225) 683-3411
NPI assigned
Aug 16, 2011
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP200591 LA Primary
Registered Nurse 163W00000X RN078895 LA

Addresses

Primary practice location

11990 Jackson St
Clinton, LA 70722-3210

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190327000133 LA Practitioner - Nurse Practitioner 4789924895 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN078895LAMDRegistered Nurse
AP200591LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care, LLC CurrentSince Dec 23, 2020 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Dec 23, 2020 Accepting new patients
Signify Health, LLC CurrentSince Jul 8, 2021 Accepting new patients

Locations

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1851670277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 JACKSON ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "GLENN",
        "middle_name": "MATTHEWS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP200591",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN078895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, LA

Sources for this page

Verify at the official NPI Registry.