Individual provider Active NPI

Glenda P Garcia, ARNP

  • Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1881602928
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30005625 Issued in WA
Practice address
1020 S 40TH Ave Ste B
Yakima, WA 98908-3800
Phone
(509) 573-3448
Fax
(509) 574-4481
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30005625 WA Primary

Addresses

Primary practice location

1020 S 40TH Ave Ste B
Yakima, WA 98908-3800

Mailing address

1020 S 40TH Ave Ste B
Yakima, WA 98908-3800
Phone (509) 573-3448

Other names 1

  • Glenda P Petrie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040206000770 WA Practitioner - Nurse Practitioner 2365335825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3902 Creekside Loop
Suite 105
Yakima, WA 98902-4876
Phone (509) 248-6414

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
  • Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30005625WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Youglycemic Diabetes Treatment & Prevention CurrentSince Sep 1, 2015 Accepting new patients

Locations

3902 Creekside Loop
Ste 105
Yakima, WA 98902
Phone (509) 248-6414

1020 S 40th Ave
Ste B
Yakima, WA 98908
Phone (509) 317-2322

Interoperability endpoints

  • Direct secure messaging: glenda.petrie.1@12728.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1881602928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S 40TH AVE STE B",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083800",
            "telephone_number": "509-573-3448",
            "fax_number": "509-574-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S 40TH AVE STE B",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083800",
            "telephone_number": "509-573-3448",
            "fax_number": "509-574-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "GLENDA",
        "middle_name": "P",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30005625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "PETRIE",
            "middle_name": "P",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.