Individual provider Active NPI

Sammy B. Glenn, MSW

  • Clinical Social Worker
  • Jensen Beach, FL
National Provider Identifier
1699064147
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
78559 Issued in CA
Practice address
PO Box 41
Jensen Beach, FL 34958-0041
Phone
(828) 999-8102
NPI assigned
Apr 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6625 TN
Clinical Social Worker 1041C0700X 78559 CA Primary

Addresses

Primary practice location

PO Box 41
Jensen Beach, FL 34958-0041

Mailing address

PO Box 41
Jensen Beach, FL 34958-0041
Phone (828) 999-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130925000878 FL Practitioner - Clinical Social Worker 4082858386 Reassigns benefits to 1 organization
I20171122001098 CA Practitioner - Clinical Social Worker 4082858386 Reassigns benefits to 2 organizations
I20190805001562 TN Practitioner - Clinical Social Worker 4082858386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78559CAMDClinical Social Worker
6625TNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince May 14, 2023 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Spectrum Programs Inc Clinical Past Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Interoperability endpoints

  • Direct secure messaging: sammyglenn@tdh.allscriptsdirect.net

Organizations & group practices 5

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1699064147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349580041",
            "telephone_number": "828-999-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349580041",
            "telephone_number": "828-999-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "SAMMY",
        "middle_name": "B.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6625",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

Verify at the official NPI Registry.