Active NPI
Tiffany Star Glenn, LMT
- Prevention Professional
- Springfield, OH
National Provider Identifier
1982138970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 33.023091
- Practice address
- 2999 E High St
Springfield, OH 45505-1428 - Phone
- (937) 888-0657
- NPI assigned
- Apr 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 33.023091 | OH | Primary |
Addresses
Primary practice location
2999 E High St
Springfield, OH 45505-1428
Mailing address
2999 E High St
Springfield, OH 45505-1428
Phone (937) 888-0657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33.023091 | OH | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1982138970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2999 E HIGH ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455051428",
"telephone_number": "937-888-0657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2999 E HIGH ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455051428",
"telephone_number": "937-888-0657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "TIFFANY",
"middle_name": "STAR",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-17",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "33.023091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.