Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy Christopher Glennon II, PA

Individual provider Physician Assistant · NPI 1447286943

Timothy Christopher Glennon II, PA is a Physician Assistant in Casper, Wyoming. Qualified in 2005, 21 years ago. Practices with Mission Health Community Multispecialty Providers LLC, a 598-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Louisiana and Wyoming.

Years since qualifying
21
Licensed in
LA, WY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4140 Centennial Hills Blvd Ste A
Casper, WY 82609
Phone: (307) 265-7205
Fax: (307) 235-6262
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence TL556 (WY)
Physician Assistant Taxonomy 363A00000X · Licence PA200064 (LA)

Record details

NPI number1447286943
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 25, 2006
Last updated in NPPESJuly 11, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Mission Health Community Multispecialty Providers Llc — 598 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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