Individual provider Active NPI

Gloried Marie Ebsworth, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
National Provider Identifier
1649408501
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 3550 Issued in FL
Practice address
1726 University Blvd S
Jacksonville, FL 32216-8929
Phone
(904) 437-1532
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO 3550 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO 3550 FL Primary

Addresses

Primary practice location

1726 University Blvd S
Jacksonville, FL 32216-8929

Mailing address

1985 Cove Dr
Largo, FL 33774-1005
Phone (305) 781-9667

Other identifiers 1

IdentifierTypeStateIssuer
006315500MedicaidFL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120821000715 FL Practitioner - Podiatry 6204083595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihn Podiatry Services PLLCGroup PAC ID 2264800564, 2 clinicians

Practice addresses (Care Compare)

5304 S Florida Ave
Suite 408
Lakeland, FL 33813-2519
Phone (863) 738-6601

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue211
Removal of skin lesions1-10
Removal of nail tissue293
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 3550FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihn Podiatry Services PLLC Podiatrist CurrentSince Oct 1, 2022 Accepting new patients
Eric D Teeman, DPM, PA CurrentSince Nov 16, 2019 Accepting new patients
Bay Area Endocrinology Associates LLC Past Accepting new patients
Martha G Herrera DPM PA Foot & Ankle Surgery Past Accepting new patients

Locations

5304 S Florida Ave
Ste 406
Lakeland, FL 33813
Phone (863) 607-4183

5304 S Florida Ave
Ste 400F
Lakeland, FL 33813
Phone (863) 738-6601

5304 S Florida Ave
Ste 408
Lakeland, FL 33813
Phone (863) 647-2614

Interoperability endpoints

  • Direct secure messaging: gloriedebsworth@afa.ssdirect.aprima.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1649408501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 COVE DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337741005",
            "telephone_number": "305-781-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168929",
            "telephone_number": "904-437-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBSWORTH",
        "first_name": "GLORIED",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 3550",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006315500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.