Kimberly Lynette Glenn, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.18224 Issued in OH

Practice address

855 Coshocton Ave Ste H
Mount Vernon, OH 43050-1975

Phone

(740) 224-3922

NPI assigned

Oct 8, 2015

Last updated

Jul 14, 2021By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Columbus Suboxone Doctors LLCGroup PAC ID 8921341256, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbus Suboxone Doctors LLC

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1760940696
  Medicare reassignment Care Compare group
• Family Urgent Care, LLC.

  • Urgent Care Clinic/Center
  • Chillicothe, OH
  • NPI 1598107526
  NPD (past)
• Pfeifer Counseling, Consulting and Training LLC

  dba Pfeifer Therapeutics

  • Professional Counselor
  • Williamstown, WV
  • NPI 1841657749
  NPD (past)

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1992176606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 COSHOCTON AVE STE H",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501975",
            "telephone_number": "740-224-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 COSHOCTON AVE STE H",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501975",
            "telephone_number": "740-224-3922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2159 Dogwood Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Wheelersburg",
            "state": "OH",
            "postal_code": "456949044",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Jackson Pike",
            "address_purpose": "LOCATION",
            "city": "Gallipolis",
            "state": "OH",
            "postal_code": "456311560",
            "country_code": "US",
            "telephone_number": "855-446-5937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "KIMBERLY",
        "middle_name": "LYNETTE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.18224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992176606",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148226",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penelope Gibson
• Kristin Gifford
• Lindsey Gilkey, APRN
• Stacy Gilley, LISW
• Cara M Glaze, LSW
• Sarah Gliniecki, O.D.
• Ashlee Goetsch, PA-C
• Rusti Goines
• Jaime T Goodman, M.D.
• Jeffrey N Goodman

• Family Nurse Practitioner in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.