MR. GLENN ALLAN CONDON (NPI# 1902957699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902957699 |
| Entity Type | Individual |
| Full Name | MR. GLENN ALLAN CONDON |
| Credential | PT |
| Practice Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Practice Telephone | 9287732054 |
| Practice Fax Number | 9287732286 |
| Mailing Telephone | 9287732054 |
| Mailing Fax Number | 9287732286 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
1581 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | PT LICENSE NUMBER | 001581 | 01 |
| Street Address |
1200 N BEAVER ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1669084190 | Margaret Grace Mcgough | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-08-17 |
| 1942818398 | Regan Rowson | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-07-21 |
| 1871118984 | Nancy Gloria Flores | Audiologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-06-15 |
| 1679100705 | Kristy Anderson | Occupational Therapist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-26 |
| 1164058087 | Bryan J Ebeling | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-23 |
| 1447808407 | Bryce Aldworth Randall | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-09-03 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1235797283 | Rebecca R Boger | Dietitian, Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659519270 | Kathleen Jodell Ganley | Physical Therapist | 208 Pine Knoll Dr Bldg 66 Rm 103, Flagstaff, AZ 86011-0001 | 2009-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821640657 | Eneida Oswalt | Physical Therapist | 1633 E Lakeside Dr Unit 133, Gilbert, AZ 85234-4971 | 2019-07-11 |
| 1124506688 | Az Therapy Spot, LLC | Physical Therapist | 3731 S Barberry Pl, Chandler, AZ 85248-4305 | 2018-08-06 |
| 1770083180 | Mariah Ashley Devries | Physical Therapist | 14557 W Indian School Rd Ste 500b, Goodyear, AZ 85395-9218 | 2018-02-13 |
| 1457805954 | Westergard Physical Therapy, Pllc | Physical Therapist | 1349 S Pheasant Dr, Gilbert, AZ 85296-9699 | 2016-08-12 |
| 1649656802 | Stephanie Michelle O'malley | Physical Therapist | 1007 N 7th St, Phoenix, AZ 85006-2728 | 2015-08-10 |
| 1215285150 | Bonnie Lynn Marlow | Physical Therapist | 8225 E Indianola Ave, Scottsdale, AZ 85251-4837 | 2012-08-27 |
| 1033478573 | Janelle Wong | Physical Therapist | 5314 N. 7th St., Phoenix, AZ 85014 | 2012-05-03 |
| 1013226182 | Joshua Bitton | Physical Therapist | 352 E Camelback Rd Ste 102, Phoenix, AZ 85012-1646 | 2010-10-06 |
| 1407164155 | Audra Pratt | Physical Therapist | 3214 W Louise Dr, Phoenix, AZ 85027-1627 | 2010-09-15 |
| 1558675918 | Sunny Days Pediatric Therapy | Physical Therapist | 870 E Lodgepole Ct, Gilbert, AZ 85298-7311 | 2010-07-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.