Matthew M Glenn (NPI# 1225080419, PAC ID# 0244134880) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1225080419 |
| PAC ID by PECOS | 0244134880 |
| Professional Enrollment ID | I20031125000088 |
| Full Name | Matthew M Glenn |
| Organization Legal Name | PINE LAKE HEALTH, LLC |
| Address |
13220 Callum Dr Suite 4 Waverly NE 68462-2562 |
| Phone Number | 4027865563 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1557372919 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 280003 | BRYAN MEDICAL CENTER |
| 280020 | CHI HEALTH ST. ELIZABETH |
| Address | Phone | Organization |
|---|---|---|
| 3901 Pine Lake Rd, Suite 211, Lincoln, NE 68516-5497 | 4024234200 | PINE LAKE HEALTH, LLC |
| 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 | 4027865563 | PINE LAKE HEALTH, LLC |
| Organization Legal Name | PINE LAKE HEALTH, LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kylie Rose Parshall | Physician Assistant | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Linda Lee Kroeger | Nurse Practitioner | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Alexandria A Arroyo | Nurse Practitioner | Pine Lake Health, LLC | 3901 Pine Lake Rd, Suite 211, Lincoln, NE 68516-5497 |
| Timothy C Kuntz | Physician Assistant | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Jacqueline A Stewart | Nurse Practitioner | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Street Address |
13220 CALLUM DR SUITE 4 |
| City | WAVERLY |
| State | NE |
| Zip | 68462-2562 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kylie Rose Parshall | Physician Assistant | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Linda Lee Kroeger | Nurse Practitioner | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Felicia F Campbell | Chiropractic | 13220 Callum Dr, Suite 2, Waverly, NE 68462-2562 | |
| Timothy C Kuntz | Physician Assistant | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Jacqueline A Stewart | Nurse Practitioner | Pine Lake Health, LLC | 13220 Callum Dr, Suite 4, Waverly, NE 68462-2562 |
| Karen J Sloboda | Chiropractic | 13220 Callum Dr, Suite 2, Waverly, NE 68462-2562 | |
| Christine A Rollman | Chiropractic | Xceed Chiropractic and Wellness Clinic PC | 13220 Callum Dr, Suite 2, Waverly, NE 68462-2562 |
| Rachelle L Rider | Chiropractic | Rider Chiropractic PC | 13220 Callum Dr, Waverly, NE 68462-2562 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Emily J Walker | Nurse Practitioner | 13851 Guildford St, Suite D, Waverly, NE 68462-1453 |
| City | WAVERLY |
| Zip Code | 68462 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WAVERLY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Matthew M Glenn.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.