Individual provider Active NPI

Glinda Wortham, APRN

  • Family Nurse Practitioner
  • Yulee, FL
National Provider Identifier
1790249092
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11001244 Issued in FL
Practice address
851042 US Highway 17
Yulee, FL 32097-2845
Phone
(904) 633-0670
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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 APRN11001244 FL Primary

Addresses

Primary practice location

851042 US Highway 17
Yulee, FL 32097-2845

Mailing address

83381 Purple Martin Dr
Yulee, FL 32097-2631
Phone (904) 631-4685

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190312000560 FL Practitioner - Nurse Practitioner 2961741822 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

1132 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 277-4690

3465 Village Ctr Dr
Jacksonville, FL 32206-8617
Phone (904) 355-1893

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Oct 1, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Mar 11, 2019 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Mar 11, 2019 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Mar 11, 2019 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

1132 S 14th St
Fernandina Beach, FL 32034
Phone (904) 277-4690

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

3465 Village Center Dr
Jacksonville, FL 32206
Phone (904) 355-1893

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

851042 US Highway 17
Yulee, FL 32097
Phone (904) 225-3824

Interoperability endpoints

  • Direct secure messaging: glinda.wortham.1@4290.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1790249092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83381 PURPLE MARTIN DR",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320972631",
            "telephone_number": "904-631-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851042 US HIGHWAY 17",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320972845",
            "telephone_number": "904-633-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "GLINDA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yulee, FL

Sources for this page

Verify at the official NPI Registry.