Physician Compare National (NPI:1285603647)

HEALTHCARE PROVIDER: CHARLES C GLENDENNING D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1285603647
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507831419
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200723000389
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GLENDENNING
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	HCC OF CARROLL COUNTY LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0042640633
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1502 N JEFFERSON ST
	Group Practice or individual's line 1 address
City	CARROLLTON
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	646331948
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6605421695
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	170012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SALINA REGIONAL HEALTH CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	261332
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CARROLL COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	171381
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	171361
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	REPUBLIC COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y