Glenwillow Physical Therapy

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

05006252A Issued in IN

Legal business name

GLENWILLOW PHYSICAL THERAPY

Practice address

12720 Bent Oak CT
Indianapolis, IN 46236-7380

Phone

(317) 345-9687

Fax

(317) 823-8645

NPI assigned

Apr 3, 2006

Organization subpart

No

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

Authorized official

Name

Beth E WatkinsNPI 1548380728

Title

President

Phone

(317) 345-9687

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beth E Watkins, PT

  • Pediatric Physical Therapist
  • Indianapolis, IN
  • NPI 1548380728

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871555292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12720 BENT OAK CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367380",
            "telephone_number": "317-345-9687",
            "fax_number": "317-823-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 BENT OAK CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367380",
            "telephone_number": "317-345-9687",
            "fax_number": "317-823-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWILLOW PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-345-9687"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": "05006252A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000377434",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary S Glenn, OD
• Kiara L Glenn
• Nancy M Glenn, NP
• Tabitha Glenn
• Cynthia Glentzer, FNP-C
• Danielle Glick, P.A.
• John Glick, PA-C
• Tiffany Marie Glick, M.A., CCC-SLP
• Michele Glidden, MSN, RN
• Logan Glidewell

• Pediatric Physical Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatric Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.