Individual provider Active NPI

Glynn M Wittber, MD

  • Obstetrics & Gynecology Physician
  • Jackson, TN
National Provider Identifier
1720056278
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD30825 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 660-8300
Fax
(731) 660-8301
NPI assigned
Mar 10, 2006
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD30825 TN Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080722000452 TN Practitioner - Obstetrics/Gynecology 5294808424 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WT University Medical Associates Inc Obstetrics & Gynecology CurrentSince Mar 1, 2022 Accepting new patients
University of Tennessee CurrentSince Jul 15, 2018 Accepting new patients
Obhg Tennessee, P.C. Obstetrics & Gynecology CurrentSince May 5, 2018 Accepting new patients
University of Tennessee Current Accepting new patients
University of Tennessee CurrentSince Jul 15, 2018 Accepting new patients
University of Tennessee Current Accepting new patients
Jackson Madison County General Hospital Past Accepting new patients

Locations

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

620 Skyline Dr
Jackson, TN 38301
Phone (731) 425-5000

1924 Alcoa Hwy
#U67
Knoxville, TN 37920
Phone (865) 305-9350

Interoperability endpoints

  • Direct secure messaging: glynnwittber@jcpa.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1720056278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-422-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-660-8300",
            "fax_number": "731-660-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTBER",
        "first_name": "GLYNN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "MD30825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.