Terrell L Glenn Iii (NPI# 1972990174, PAC ID# 8820394976) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1972990174 |
| PAC ID by PECOS | 8820394976 |
| Professional Enrollment ID | I20181102001246 |
| Full Name | Terrell L Glenn Iii |
| Organization Legal Name | WVP MEDICAL GROUP LLC |
| Address |
1430 Monmouth St Independence OR 97351-1127 |
| Phone Number | 5038381133 |
| Gender | M |
| Medical School | UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4486627965 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 381308 | WEST VALLEY HOSPITAL |
| 380051 | SALEM HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1430 Monmouth St, Independence, OR 97351-1127 | 5038381133 | WVP MEDICAL GROUP LLC |
| Organization Legal Name | WVP MEDICAL GROUP LLC |
| Physicians | 56 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy Lynne Card | Family Medicine | Wvp Medical Group LLC | 5050 Skyline Village Loop S, Salem, OR 97306-9490 |
| Shelly A Wimmer | Physician Assistant | Wvp Medical Group LLC | 1430 Monmouth St, Independence, OR 97351-1127 |
| Robin M Jewett | Physician Assistant | Wvp Medical Group LLC | 5100 River Rd N, Keizer, OR 97303-5371 |
| Ginger A Denney | Nurse Practitioner | Wvp Medical Group LLC | 1000 Southeast Uglow Ave, Dallas, OR 97338-2645 |
| Shanna Lyn Howald | Clinical Social Worker | Wvp Medical Group LLC | 2485 12th St Se, Salem, OR 97302-2151 |
| David L Edmonds | Family Practice | Wvp Medical Group LLC | 5050 Skyline Vilge Loop S, Salem, OR 97306-9490 |
| Jennifer L Lee | Nurse Practitioner | Wvp Medical Group LLC | 5100 River Rd N, Keizer, OR 97303-5371 |
| Madison N Buda | Physician Assistant | Wvp Medical Group LLC | 5100 River Rd N, Keizer, OR 97303-5371 |
| Jeffery Brown | Internal Medicine | Wvp Medical Group LLC | 5050 Skyline Village Loop S, Salem, OR 97306-9490 |
| Eric A Laro | General Surgery | Wvp Medical Group LLC | 5050 Skyline Village Loop S, Salem, OR 97306-9490 |
| Street Address |
1430 MONMOUTH ST |
| City | INDEPENDENCE |
| State | OR |
| Zip | 97351-1127 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shelly A Wimmer | Physician Assistant | Wvp Medical Group LLC | 1430 Monmouth St, Independence, OR 97351-1127 |
| Mary S Placek | Family Medicine | Wvp Medical Group LLC | 1430 Monmouth St, Independence, OR 97351-1127 |
| Keith A White | Family Practice | Wvp Medical Group LLC | 1430 Monmouth St, Independence, OR 97351-1127 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark J Diaz | Chiropractic | 226 S Main St, Suite D, Independence, OR 97351-2069 | |
| Sharon Cash Thornton | Chiropractic | Am and Sharon C Thornton | 1650 Monmouth St, Independence, OR 97351-9726 |
| Alpheus Martin Thornton Jr. | Chiropractic | Am and Sharon C Thornton | 1650 Monmouth St, Independence, OR 97351-9726 |
| City | INDEPENDENCE |
| Zip Code | 97351 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | INDEPENDENCE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Terrell L Glenn Iii.
| 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.