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IDEAL IMAGE
NPI 1679878904
Nurse Practitioner - Family in Jacksonville, FL

Active since January 18, 2011
4866 BIG ISLAND DR, STE #5, JACKSONVILLE, FL 32246(904) 652-0652 Get Directions Write a Review

NPPES record last updated: January 18, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ideal Image NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDEAL IMAGE (NPI 1679878904) is a healthcare organization registered as a family in Jacksonville, Florida and active in the NPI registry since January 2011. The organization lists Richard Dean Glassman, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1679878904
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameIDEAL IMAGE
Location Address4866 BIG ISLAND DR, STE #5Jacksonville, FL 32246-7498
Mailing Address4866 Big Island Dr, Ste #5Jacksonville, FL 32246-7498
Phone(904) 652-0652
Organization SubpartNo
Authorized OfficialRichard Dean GlassmanMedical Director · (904) 652-0652
Enumeration DateJanuary 18, 2011
✔ NPI 1679878904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · 9193543
4866 BIG ISLAND DR, Jacksonville, FL 32246
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY ELIZABETH MACLEAN ARNP
Nurse Practitioner (Adult Health)
4866 BIG ISLAND DR, SUITE 5
JACKSONVILLE, FL 32246
Duval County (904) 652-0652
HEATHER GILMORE APRN
Nurse Practitioner
4866 BIG ISLAND DR
JACKSONVILLE, FL 32246
Duval County (904) 652-0652
DR. KIMBERLY MICHELLE ORTIZ DNP
Nurse Practitioner (Family)
4866 BIG ISLAND DR
JACKSONVILLE, FL 32246
Duval County (904) 652-0652

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ideal Image's NPI number?

The NPI number for Ideal Image is 1679878904. It was assigned to this organization in the NPPES registry on January 18, 2011.

Where is Ideal Image located?

Ideal Image is located at 4866 Big Island Dr Ste #5, Jacksonville, FL 32246. The listed phone number is (904) 652-0652.

What is Ideal Image's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Ideal Image was last updated on January 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.