TARA JACKSON GLENN MD
NPI 1992060974
Pediatrics - Neonatal-Perinatal Medicine in La Jolla, CA
About Tara Jackson Glenn Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TARA JACKSON GLENN MD (NPI 1992060974) is an individual neonatal-perinatal medicine provider in La Jolla, California, licensed in California (A170207) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Locations 2
Other Identifiers 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)
Tara Jackson Glenn Md 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.
LA JOLLA, CA 92037
LA JOLLA, CA 92037
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 Tara Glenn's NPI number?
The NPI number for Tara Glenn is 1992060974. It was assigned to this individual provider in the NPPES registry on July 6, 2012. The provider is also known as Tara Christine Jackson.
Where is Tara Glenn located?
Tara Glenn practices at 9300 Campus Point Dr, La Jolla, CA 92037. The listed phone number is (858) 249-5800.
What is Tara Glenn's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.
Is Tara Glenn enrolled in Medicare?
Yes. Tara Glenn is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Tara Glenn was last updated on April 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Tara Jackson Glenn, MD · NPI 1992060974
Neonatal-Perinatal Medicine physician in La Jolla, California. Individual provider, active in the CMS NPPES registry since July 6, 2012.
## Identity
- **NPI:** 1992060974 (Entity type: Individual)
- **Enumerated:** July 6, 2012
- **Primary specialty:** Pediatrics - Neonatal-Perinatal Medicine · taxonomy 2080N0001X
- **State license:** A170207 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 9300 CAMPUS POINT DR, La Jolla, CA 92037-1300
- **Phone:** (858) 249-5800
## 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:** April 8, 2021
- **Other identifiers:** Medicaid 0148250 (OH)
---
Source: [NPI Profile](https://npiprofile.com/npi/1992060974) · Data from the CMS NPPES public registry.