Individual provider Active NPI

Sandra Hills Glenn, FNP-C

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1982999264
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06302 Issued in LA
Practice address
8119 Picardy Ave
Baton Rouge, LA 70809-3515
Phone
(225) 765-3076
Fax
(225) 765-1076
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06302 LA Primary

Addresses

Primary practice location

8119 Picardy Ave
Baton Rouge, LA 70809-3515

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5727

Other practice location 1

12525 Perkins Rd
Suite A
Baton Rouge, LA 70810-1907
Phone (225) 761-4256

Other identifiers 1

IdentifierTypeStateIssuer
2177869MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sglenn2662@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110824000772 LA Practitioner - Nurse Practitioner 5496925745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

12525 Perkins Rd a
Baton Rouge, LA 70810-1907
Phone (225) 765-4256

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner CurrentSince Nov 2, 2016 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Nov 2, 2016 Accepting new patients
Ascension Care Center Past Accepting new patients
Nexion Health at Gonzales, Inc. Past Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Past Accepting new patients
Our Lady of the Lake Hospital Inc Past Accepting new patients
Ascension Oaks Nursing & Rehabilitation Center, LLC Past Accepting new patients

Locations

8340 Baringer Foreman Rd
Baton Rouge, LA 70817
Phone (225) 275-3203

5247 Didesse Dr
Baton Rouge, LA 70808
Phone (225) 765-2273

12525 Perkins Rd
#A
Baton Rouge, LA 70810
Phone (225) 761-4256

4250 Essen Ln
Baton Rouge, LA 70809
Phone (225) 765-3076

8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806
Phone (225) 765-4226

5550 Thomas Rd
Baton Rouge, LA 70811
Phone (225) 774-2141

18180 Jefferson Hwy
Baton Rouge, LA 70817
Phone (225) 291-8474

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8119 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 765-3076

18901 Greenwell Springs Rd
Greenwell Springs, LA 70739
Phone (225) 924-9985

18989 Old Scenic Hwy
Zachary, LA 70791
Phone (225) 654-6140

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1982999264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8119 PICARDY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093515",
            "telephone_number": "225-765-3076",
            "fax_number": "225-765-1076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12525 Perkins Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708101907",
            "country_code": "US",
            "telephone_number": "225-761-4256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "SANDRA",
        "middle_name": "HILLS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177869",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sglenn2662@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sglenn2662@direct.casso.us.com",
            "address_1": "8119 Picardy Ave",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8119 Picardy Ave",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.