Glen Ray Patton, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05-19924 Issued in KS

Practice address

606 Mulberry Rd
Derby, KS 67037-3532

Phone

(316) 788-3787

Fax

(316) 788-6930

NPI assigned

Feb 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glen.patton@tfmc.directbygreenway.com
• Direct secure messaging: glen.patton@khindirect.org

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.

• Tanglewood Family Medical Center PA

  • Family Medicine Physician
  • Derby, KS
  • NPI 1659472306
  Medicare reassignment NPD

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1922073337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 MULBERRY RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373532",
            "telephone_number": "316-788-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 MULBERRY RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373532",
            "telephone_number": "316-788-3787",
            "fax_number": "316-788-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "GLEN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-19924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00099501",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camilo H Palacio, MD
• Doyle E Palmer III, OT
• Constantine Paul Panakos, DO
• Brandi Pappan
• Andrea Parker, RPH
• Malissa Kay Paxton, RPAC
• Pearl Girl Clinics LLC
• Taylor Peck, CF-SLP
• Janet Pham, PHARMD
• Loan Kim Phan, APRN

• Family Medicine Physician in Derby, KS
• Providers in Derby, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.
• 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.