Individual provider Active NPI

Glennal Verbois, MD

  • Physical Medicine & Rehabilitation Physician
  • Brooksville, FL
National Provider Identifier
1992743967
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME107359 Issued in FL
Practice address
12440 Cortez Blvd
Brooksville, FL 34613-2628
Phone
(352) 952-4250
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME107359 FL Primary

Addresses

Primary practice location

12440 Cortez Blvd
Brooksville, FL 34613-2628

Mailing address

PO Box 10183
Brooksville, FL 34603-0183
Phone (850) 377-2820

Other identifiers 1

IdentifierTypeStateIssuer
03081893MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20211006003446 AL Practitioner - Physical Medicine and Rehabilitation 7517948243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Louisiana State University School of Medicine in New Orleans, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3715 Hwy 280/431 N
Phenix City, AL 36867-2363
Phone (334) 732-2200

Hospital & facility affiliations

  • Rehabilitation Hospital of Phenix City Inpatient rehabilitation facility, Phenix City, AL, CCN 013033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Past Accepting new patients
North Mississippi Medical Center Physical Medicine & Rehabilitation Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1992743967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10183",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346030183",
            "telephone_number": "850-377-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346132628",
            "telephone_number": "352-952-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERBOIS",
        "first_name": "GLENNAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME107359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03081893",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.