Individual provider Active NPI

Gretta Elaine Langley, DNP, FNP-BC

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1194214148
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9272901 Issued in FL
Practice address
14043 N Main Street Suite 107
Jacksonville, FL 32218
Phone
(904) 902-1201
Fax
(904) 902-1202
NPI assigned
May 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9272901 FL Primary

Addresses

Primary practice location

14043 N Main Street Suite 107
Jacksonville, FL 32218

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011002959 FL Practitioner - Nurse Practitioner 1153673504 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9272901FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Jun 20, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jan 1, 2019 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Sep 10, 2018 Accepting new patients
Millennium Physician Group LLC CurrentSince Jun 20, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Sep 10, 2018 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Past Accepting new patients
University of Florida Jacksonville Physicians, Inc. Past Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

2377 Dunn Ave
Jacksonville, FL 32218
Phone (904) 633-0700

3122 New Berlin Rd
Jacksonville, FL 32226
Phone (904) 633-0340

14043 N Main St
Ste 107
Jacksonville, FL 32218
Phone (904) 902-1201

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: gretta.langley.1@4290.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1194214148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14043 N MAIN STREET SUITE 107",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-902-1201",
            "fax_number": "904-902-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLEY",
        "first_name": "GRETTA",
        "middle_name": "ELAINE",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-05",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9272901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.