Individual provider Active NPI

Bernard Joseph Wortman III, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1386181238
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN195733 Issued in GA
Practice address
2501 N Patterson St
Valdosta, GA 31602-1735
Phone
(706) 294-1055
NPI assigned
Jan 30, 2017
Last updated
Jan 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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 RN195733 GA Primary

Addresses

Primary practice location

2501 N Patterson St
Valdosta, GA 31602-1735

Mailing address

2115 Westfield Dr
Valdosta, GA 31602-2154
Phone (706) 294-1055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170705000613 GA Practitioner - Nurse Practitioner 5092084145 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ibrahim Heart Clinic PLLCGroup PAC ID 4688958648, 43 clinicians
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

1921 Alice St
Suite 4a
Waycross, GA 31501-6202
Phone (904) 580-4730

2409 N Patterson St
Suite 230a
Valdosta, GA 31602-2512
Phone (229) 259-4369

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
SGMC Affiliated Services LLC Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia CurrentSince Mar 26, 2017 Accepting new patients
SGMC Physician Network Inc CurrentSince Sep 1, 2022 Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Mar 26, 2017 Accepting new patients
Ibrahim Heart Clinic PLLC CurrentSince Aug 26, 2025 Accepting new patients

Locations

5150 Belfort Rd
Bldg 400
Jacksonville, FL 32256
Phone (904) 296-0900

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

1921 Alice St
Ste 4A
Waycross, GA 31501
Phone (912) 283-5616

Organizations & group practices 6

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

Hospital & facility affiliations 1

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1386181238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 WESTFIELD DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022154",
            "telephone_number": "706-294-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "706-294-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTMAN",
        "first_name": "BERNARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN195733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.