Gary B Glenn, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RNA-706A Issued in ID

Practice address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Phone

(208) 765-8585

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e8b4f872-6ea1-4b26-a974-041b5fb4c57b/

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.

• Anesthesia Associates of Coeur D Alene PLLC

  • Anesthesiology Physician
  • Coeur D Alene, ID
  • NPI 1962440966

  ID, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Benewah Community Hospital

  • Rural Health Clinic/Center
  • St Maries, ID
  • NPI 1386632180

  ID

  Medicare reassignment NPD
• Benewah Community Hospital

  • Critical Access Hospital
  • St Maries, ID
  • NPI 1548320435

  ID, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC

  • Anesthesiology Physician
  • Richland, WA
  • NPI 1013940253

  Nurse Anesthetist, Certified Registered, WA

  Medicare reassignment NPD
• Helping Hands Chiropractic and Wellness Center

  • Primary Care Clinic/Center
  • Coeur D Alene, ID
  • NPI 1194126003
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409

  Hospital

  Care Compare affiliation

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates of Coeur D Alene PLLC 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1962579797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 IRONWOOD PL STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142662",
            "telephone_number": "208-765-8585",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-765-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9961 Sierra Ave",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923356720",
            "country_code": "US",
            "telephone_number": "909-427-3910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "GARY",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "RN635391",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-706A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan John Gilles, MD
• Erin Gilliland
• Scott Anthony Gittens, LMSW
• Jenny Marie Gjoraas, LMSW
• Glacier Prosthetic Care, Inc.
• Garrett Glover
• Kevin Glover
• Taylor Glovsky
• Stephen Godfrey
• Cindy R. Goff, M.A.,SLP-CCC

• All providers in Coeur D Alene, ID
• Certified Registered Nurse Anesthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.