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Deactivated NPI 1720325954 Deactivated / Inactive NPI Male Practitioner

Dr. Glen R Edgerton , MD

Internal Medicine • Fairview, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Glen Edgerton has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 08, 2013
NPI Deactivation Date February 03, 2022
Total Practice Duration ~9 Years of Practice (2013 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Glen Edgerton, MD was a registered Internal Medicine practicing in Fairview, OR. Throughout an active medical career spanning 9 years, Dr. Edgerton provided care at the practice location at 3797 NE FAIRVIEW LAKE WAY until profile deactivation on 2022-02-03.

Practice Location & Contact Primary Location

Practice Address

3797 Ne Fairview Lake Way

Fairview, OR 97024

Telephone 5036658751

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Fairview, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.1 Yrs
Regional Practice Density
1 Specialists

Practicing in Fairview, OR (2185 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

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OR 5768

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated February 03, 2022

Record deactivated on February 03, 2022

NPI Profile Active January 08, 2013

NPI status registered as active in NPPES database

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Updated Practice Location January 08, 2013

Registered at 3797 NE FAIRVIEW LAKE WAY, FAIRVIEW, OR 97024 (Tel: 5036658751)

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Updated Business Mailing Address January 08, 2013

Registered at 3797 NE FAIRVIEW LAKE WAY, FAIRVIEW, OR 97024 (Tel: 5036658751)

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Provider Name / Credentials Updated January 08, 2013

Recorded as GLEN EDGERTON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2013

Internal Medicine (License #5768 in OR)

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Initial NPI Registration & Enumeration January 08, 2013

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: 1720325954
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 08, 2013
Last Update: January 08, 2013
Deactivation Date: February 03, 2022

Mailing Address

3797 Ne Fairview Lake Way

Fairview, OR 97024

Phone: 5036658751

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.