TAHIRA KANEKA LOVE-GLENN NURSE PRACTITIONER
NPI 1275097362
Nurse Practitioner - Adult Health in Conyers, GA
About Tahira Kaneka Love-glenn Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TAHIRA KANEKA LOVE-GLENN NURSE PRACTITIONER (NPI 1275097362) is an individual adult health provider in Conyers, Georgia, licensed in Georgia (RN239826) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tahira Kaneka Love-glenn Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Tahira Love-glenn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Novi, MI 48375
- Reassigned Medicare billing, Georgia enrollment
- 110 clinicians in this Medicare group
Novi, MI 48375
- Reassigned Medicare billing, Georgia enrollment
- 29 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tahira Love-glenn's NPI number?
The NPI number for Tahira Love-glenn is 1275097362. It was assigned to this individual provider in the NPPES registry on January 23, 2019.
Where is Tahira Love-glenn located?
Tahira Love-glenn practices at 3565 Georgia Highway 20 SE, Conyers, GA 30013. The listed phone number is (404) 430-1757.
What is Tahira Love-glenn's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Tahira Love-glenn enrolled in Medicare?
Yes. Tahira Love-glenn is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Tahira Love-glenn's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tahira Love-glenn reassigns Medicare benefits to 2 organizations: Theoria Medical (Novi, MI) and Complexcare Medical Group Southeast H PLLC (Novi, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tahira Love-glenn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Tahira Love-glenn was last updated on August 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tahira Kaneka Love-Glenn, NURSE PRACTITIONER · NPI 1275097362
Adult Health physician in Conyers, Georgia. Individual provider, active in the CMS NPPES registry since January 23, 2019.
## Identity
- **NPI:** 1275097362 (Entity type: Individual)
- **Enumerated:** January 23, 2019
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** RN239826 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 3565 GEORGIA HIGHWAY 20 SE, Conyers, GA 30013-2800
- **Phone:** (404) 430-1757
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Theoria Medical (NPI 1609362375, Novi, MI); Complexcare Medical Group Southeast H PLLC (NPI 1083508238, Novi, MI) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 10, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1275097362) · Data from the CMS NPPES public registry.