GLENN JORDAN-FAIRLEY
NPI 1750239984
Student in an Organized Health Care Education/Training Program in Plantation, FL
About Glenn Jordan-fairley NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GLENN JORDAN-FAIRLEY (NPI 1750239984) is an individual student in an organized health care education/training program in Plantation, Florida and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Glenn Jordan-fairley is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PLANTATION, FL 33324
PLANTATION, FL 33324
PLANTATION, FL 33324
PLANTATION, FL 33324
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 Glenn Jordan-fairley's NPI number?
The NPI number for Glenn Jordan-fairley is 1750239984. It was assigned to this individual provider in the NPPES registry on March 21, 2026. The provider is also known as Glenn Jordan.
Where is Glenn Jordan-fairley located?
Glenn Jordan-fairley practices at 8201 W Broward Blvd, Plantation, FL 33324. The listed phone number is (954) 298-6155.
What is Glenn Jordan-fairley's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Glenn Jordan-fairley enrolled in Medicare?
Yes. Glenn Jordan-fairley is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Glenn Jordan-fairley was last updated on March 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Glenn Jordan-Fairley · NPI 1750239984
Student in an Organized Health Care Education/Training Program provider in Plantation, Florida. Individual provider, active in the CMS NPPES registry since March 21, 2026.
## Identity
- **NPI:** 1750239984 (Entity type: Individual)
- **Enumerated:** March 21, 2026
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 8201 W BROWARD BLVD, Plantation, FL 33324-2701
- **Phone:** (954) 298-6155
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1750239984) · Data from the CMS NPPES public registry.