Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154475523 Individual Practitioner Male Practitioner

Dr. Theodore E Glynn , MD

Specialist • Lansing, MI

Professional Overview & Biography Verified Profile Summary

Dr. Theodore Glynn, MD is a registered healthcare professional specializing in Specialist in Lansing, MI. Practice services are available at 5303 S CEDAR ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5303 S Cedar St

Lansing, MI 489113800

Telephone 5178874311
Associated Practice Facility / Clinic
🏢 Tri-County Office On Aging Facility NPI 1811007875

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Lansing, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 37.1 Yrs
Regional Practice Density
13 Specialists

Practicing in Lansing, MI (867 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MI 4301071075

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
4548289 (MI)
Commercial Insurance / Payer ID Tax Id
382168683 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Clinton Mireles , BA, CHW

Community Health Worker

NPI 1013863257

Bachelor of Arts, CHW

Alysha Ausmus , PA-C

Physician Assistant

NPI 1316617194

Physician Assistant (Certified)

Stacy Hofmeister , RDH

Dental Hygienist

NPI 1447750609

Registered Dental Hygienist

Kyle Norman

Dental Hygienist

NPI 1609179472
Jami Opalek

Dental Hygienist

NPI 1699078469
Jamie Lenon

Dental Hygienist

NPI 1891098661

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active March 21, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 21, 2017

Registered at 5303 S CEDAR ST, LANSING, MI 489113800 (Tel: 5178874311)

📍
Updated Business Mailing Address March 21, 2017

Registered at 1215 E MICHIGAN AVE, LANSING, MI 489121811 (Tel: 5173643895)

👤
Provider Name / Credentials Updated March 21, 2017

Recorded as THEODORE GLYNN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 21, 2017

Specialist (License #4301071075 in MI)

NPI Profile Active October 21, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location October 21, 2008

Registered at 401 W GREENLAWN AVE, LANSING, MI 489102819 (Tel: 5174871288)

📍
Updated Business Mailing Address October 21, 2008

Registered at 1031 E SAGINAW STREET, LANSING, MI 48906 (Tel: 5174871288)

👤
Provider Name / Credentials Updated October 21, 2008

Recorded as THEODORE GLYNN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 21, 2008

Specialist (License #4301071075 in MI)

🟢
Initial NPI Registration & Enumeration January 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154475523
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 23, 2007
Last Update: March 21, 2017
Sole Proprietor: No

Mailing Address

1215 E Michigan Ave

Lansing, MI 489121811

Phone: 5173643895

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.