Individual provider Active NPI

Elizabeth Anne Worsham, M.D.

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1649584301
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
117411 Issued in FL
Practice address
1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone
(904) 475-5800
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2010018498 MO
Psychiatry Physician 2084P0800X 117411 FL Primary

Addresses

Primary practice location

1536 N Jefferson St
Jacksonville, FL 32209-6525

Mailing address

1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone (904) 475-5800

Other names 1

  • Dr. Elizabeth Anne Peek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
117411FLMDPsychiatry Physician
2010018498MOMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1649584301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-475-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-475-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSHAM",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2010018498",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "117411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PEEK",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.