Individual provider Active NPI

Glenn Molin, D.C.

  • Chiropractor
  • Glenelg, MD
National Provider Identifier
1871960344
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03851 Issued in MD
Practice address
3881 Ten Oaks Rd
Ste 1D
Glenelg, MD 21737-9760
Phone
(301) 231-0050
NPI assigned
Aug 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03851 MD Primary

Addresses

Primary practice location

3881 Ten Oaks Rd
Ste 1D
Glenelg, MD 21737-9760

Mailing address

13125 Fox Path LN
West Friendship, MD 21794-9536
Phone (540) 287-1776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210225002616 MD Practitioner - Chiropractic 7416962949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3881 Ten Oaks Rd
Suite 1D
Glenelg, MD 21737-9760
Phone (443) 583-0225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S03851MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Wellness, LLC Chiropractor CurrentSince Feb 15, 2021 Accepting new patients
M-Squared Diagnostics, LLC PastSince Apr 30, 2003 Accepting new patients
Alydan, LLC PastSince Feb 21, 2021 Accepting new patients

Locations

3881 10 Oaks Rd
Ste 1D
Glenelg, MD 21737
Phone (301) 231-0050

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1871960344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13125 FOX PATH LN",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949536",
            "telephone_number": "540-287-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3881 TEN OAKS RD",
            "address_2": "STE 1D",
            "city": "GLENELG",
            "state": "MD",
            "postal_code": "217379760",
            "telephone_number": "301-231-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLIN",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenelg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.