Glen H Stribling, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

516 Issued in MS

Practice address

110 E Georgetown St
Crystal Springs, MS 39059-2746

Phone

(601) 892-5053

Fax

(601) 892-5741

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1881685220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E GEORGETOWN ST",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592746",
            "telephone_number": "601-892-5053",
            "fax_number": "601-892-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E GEORGETOWN ST",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592746",
            "telephone_number": "601-892-5053",
            "fax_number": "601-892-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRIBLING",
        "first_name": "GLEN",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087004",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410044093",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Specialty Medical Supply of Mississippi, Inc.
• Thomas Edward Spell Jr., R.PH.
• Kristy Lynn Staten, LCSW
• Stovall Transportation LLC
• Frank Stovall
• Tina Andrea Tanner
• Tender Care Nursing
• Therapy Cares,LLC
• Delendtricus Thompson, CCC-SLP
• Cynthia Tronstad, PT

• Optometrist in Crystal Springs, MS
• Providers in Crystal Springs, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.